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Precision Measurements and Parametric Models of Vertebral Endplates
Published on: September 17, 2019
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Measurement Performance of a Computer Assisted Vertebral Motion Analysis System
Reginald J Davis1, David C Lee2, Chip Wade3
1Department of Neurosurgery, Greater Baltimore Medical Center, Baltimore, MD.
International Journal of Spine Surgery
|August 15, 2015
Summary
The Vertebral Motion Analysis (VMA) system offers superior accuracy and reliability for detecting lumbar spine instability compared to traditional fluoroscopic flexion extension (FE) radiographs. This computer-assisted method improves diagnostic performance for identifying spinal instability.
Area of Science:
- Spine biomechanics
- Radiographic imaging analysis
- Medical diagnostics
Background:
- Lumbar spine instability presents a significant healthcare cost in the US.
- Current diagnostic thresholds for radiographic instability lack precise definition.
Purpose of the Study:
- To evaluate the performance of sagittal lumbar intervertebral measurements.
- To compare computer-assisted measurements using video-fluoroscopic motion sequences with traditional methods.
Main Methods:
- Retrospective analysis of 2239 intervertebral levels from 509 symptomatic patients and 287 from 73 asymptomatic individuals.
- Comparison of Vertebral Motion Analysis (VMA) system with fluoroscopic flexion extension (FE) static radiographs.
- Evaluation of sensitivity, specificity, predictive values, prevalence, and reliability (CR, LOA, ICC).
Main Results:
- VMA demonstrated superior specificity, sensitivity, negative predictive value (NPV), and reliability compared to FE.
- Specificity for VMA was 99.4% (IVR) and 99.1% (IVT) vs. 98.3% and 98.2% for FE.
- Sensitivity was 41.2-44.6% greater with VMA; NPV was 91% (IVR) and 88% (IVT) with VMA vs. 62-66% for FE.
Conclusions:
- The Vertebral Motion Analysis (VMA) system exhibits enhanced measurement performance for detecting radiographic lumbar instability.
- VMA provides a more reliable and accurate method compared to conventional FE radiographs.
