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Calibrated Forceps Model of Spinal Cord Compression Injury
Published on: April 24, 2015
Reliability analysis of the epidural spinal cord compression scale.
Mark H Bilsky1, Ilya Laufer, Daryl R Fourney
1Departments of Neurosurgery, Box 71, 1275 York Ave, New York, New York 10065, USA. bilskym@mskcc.org
Journal of Neurosurgery. Spine
|September 3, 2010
Summary
A new 6-point MR imaging scale reliably grades epidural spinal cord compression (ESCC). T2-weighted images are best for assessing ESCC, aiding treatment decisions for spinal metastases.
Area of Science:
- Radiology
- Neurosurgery
- Oncology
Background:
- Advances in imaging and radiation therapy have transformed metastatic epidural tumor treatment.
- High-grade epidural spinal cord compression (ESCC) often indicates surgery, but lacks a precise definition.
- A clear ESCC grading system is needed for advancing spine tumor treatment paradigms.
Purpose of the Study:
- To determine the reliability and validity of a 6-point, MR imaging-based grading system for ESCC.
- To establish a standardized method for assessing the severity of spinal cord compression due to metastatic tumors.
Main Methods:
- A survey assessing a 6-point ESCC grading scale was distributed to 7 spine surgeons.
- MR images (sagittal, axial T1, T2, and enhanced T1) of 25 spinal tumors were reviewed.
- Inter- and intrarater reliability was assessed by administering the survey three times over 2-week intervals.
Main Results:
- The grading scale demonstrated good to excellent inter- and intrarater reliability when using T2-weighted axial images.
- T2-weighted images proved superior to T1-weighted images (with or without Gd contrast) for indicating ESCC.
Conclusions:
- The developed ESCC scale is a valid and reliable tool for grading ESCC using T2-weighted MR images.
- This scale aligns with modern treatment advances for spinal metastases.
- It can serve as a classification scheme for multicenter clinical trials and outcome studies.
