Related Experiment Video
Updated: Mar 16, 2026
05:52
Novel Mini-open Transforaminal Lumbar Interbody Fusion
Published on: June 6, 2025
875
Interobserver and Intraobserver Reliability in the Radiologic Assessment of Lumbar Interbody Fusion
Robert J Kroeze1, Harm C A Graat, Winand J Pluymakers
1*Department of Orthopaedic Surgery, Medisch Centrum Alkmaar, Alkmaar †Department of Orthopaedic Surgery, St. Antonius Ziekenhuis, Nieuwegein ‡Department of Radiology, Medisch Centrum Alkmaar, Alkmaar, The Netherlands.
Clinical Spine Surgery
|August 23, 2016
Summary
The Burkus classification showed the best reliability for assessing spinal fusion, though moderate interobserver agreement indicates a need for improved systems. This study compared three radiologic fusion classifications.
Area of Science:
- Spine surgery
- Radiology
- Orthopedics
Background:
- Radiographic spinal fusion assessment is vital for lumbar interbody fusion outcomes.
- Existing classification systems lack comparative reliability data.
- A reliable and reproducible scoring system is essential for clinical evaluation.
Purpose of the Study:
- Compare the intraobserver and interobserver reliability of three distinct radiologic spinal fusion scoring systems.
- Identify the most valid classification system for assessing interbody fusion.
- Evaluate the reproducibility of spinal fusion assessment methods.
Main Methods:
- Retrospective cohort study of 50 patients undergoing anterior lumbar interbody fusion.
- Analysis of plain radiographs (AP, lateral, flexion-extension) using three classification systems (Brantigan, Burkus, Radiographic Score).
- Evaluation by blinded musculoskeletal radiologists and orthopedic spinal surgeons.
Main Results:
- The Burkus classification demonstrated moderate interobserver and substantial to perfect intraobserver agreement.
- Brantigan and Radiographic Score classifications showed only fair interobserver agreement.
- No significant reliability differences were observed between radiologists and orthopedic surgeons.
Conclusions:
- The Burkus classification system was the most reliable among the evaluated methods.
- Moderate interobserver agreement for the Burkus system highlights limitations.
- A more reliable classification system for radiographic assessment of lumbar interbody fusion is still needed.
