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Posterior disk displacement: morphologic assessment and measurement reliability-lumbar spine
J R Cooley1, C D Danielson, G D Schultz
1Department of Radiology, Los Angeles College of Chiropractic, Whittier, Calif 90604, USA.
Journal of Manipulative and Physiological Therapeutics
|June 21, 2001
Summary
Chiropractic radiologists showed good agreement in assessing disk displacement on MRI scans, but intraexaminer reliability was lower than expected. A simple millimetric ruler is a reliable tool for disk measurement.
Area of Science:
- Radiology and Imaging
- Spinal Biomechanics
- Diagnostic Accuracy
Background:
- Limited data exists on iatrogenic disk herniations after manipulation.
- Assessing disk displacement size is crucial for causal relationship studies.
- Evaluating the reliability of chiropractic radiologists and measurement tools is necessary.
Purpose of the Study:
- To determine average measurements for normal and displaced intervertebral disks.
- To assess the reliability of disk displacement measurements by chiropractic radiologists.
Main Methods:
- Intraobserver and interobserver reliability study of disk displacement on 122 MRI scans.
- Six disk categories were graded; digitizer and ruler measurements were compared.
- Intraclass correlation coefficient and kappa statistics analyzed variations; Pearson's r assessed device correlation.
Main Results:
- Distinct size differences were observed between various disk displacement types.
- Interexaminer agreement for disk presence and classification was good (85% and 76%).
- Intraexaminer agreement was lower (76% and 62-69%), with most disagreement on normal vs. bulged disks. Ruler and digitizer correlation was high (0.968).
Conclusions:
- Interexaminer reliability for disk assessment and measurement is good.
- Intraexaminer reliability was lower than anticipated.
- A millimetric ruler is a viable and acceptable alternative to digital measurement devices.