Quantifying cervical spondylosis: reliability testing of a coherent CT-based scoring system

Area of Science:

• Radiology
• Orthopedics
• Medical Imaging

Background:

• Cervical spine degeneration grading is clinically significant.
• Current Computed Tomography (CT) assessments lack a user-friendly, reliable scoring system for cervical spondylosis.
• Existing methods necessitate a standardized approach for CT-based evaluation.

Purpose of the Study:

• To develop and validate a reliable scoring system for cervical spondylosis using CT scans.
• To establish a comprehensive assessment for both disc and facet joint degeneration.
• To enhance the clinical utility of radiological investigations for cervical spine conditions.

Main Methods:

• A scoring system was developed for cervical disc degeneration (disc height, osteophytes, endplate sclerosis) and facet joint degeneration (joint space narrowing, osteophytes, articular surface irregularity).
• Three independent raters assessed CT scans of 20 patients with neck pain.
• Two raters repeated assessments after three months to evaluate intra- and inter-rater reliability.

Main Results:

• The developed scoring systems showed acceptable to excellent intra- and inter-rater reliability.
• The total disc degeneration score achieved moderate inter-rater reliability (kappa 0.47) and good intra-rater agreement (ICC 0.60-0.67).
• The total facet joint degeneration score demonstrated moderate inter-rater reliability (kappa 0.54) and excellent intra-rater agreement (ICC 0.75).
• A combined total degeneration score yielded high inter-rater agreement (0.695) and intra-rater reliability (ICC 0.73-0.82).

Conclusions:

• A reliable, coherent scoring system for assessing cervical spondylosis on CT scans has been established.
• The system effectively evaluates both disc and facet joint degeneration, meeting reliability standards.
• This CT-based scoring system offers a valuable tool for clinical practice and radiological assessment of cervical spine degeneration.