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Videofluoroscopy in cervical spine trauma: an interinterpreter reliability study

A C Croft1, J S Krage, D Pate

  • 1Department of Diagnosis, Los Angeles College of Chiropractic, CA.

Journal of Manipulative and Physiological Therapeutics
|January 1, 1994
PubMed
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Radiologists showed moderate agreement in interpreting cervical videofluoroscopic (VF) studies for intersegmental motion. Experience and training influenced agreement, suggesting a need for standardized VF interpretation protocols.

Area of Science:

  • Radiology
  • Spinal Biomechanics
  • Medical Imaging Analysis

Background:

  • Cervical acceleration/deceleration (CAD) trauma can lead to intersegmental spinal instability.
  • Videofluoroscopic (VF) studies are used to assess spinal motion.
  • Inter-observer reliability in VF interpretation is crucial for accurate diagnosis.

Purpose of the Study:

  • To assess inter-observer agreement among radiologists interpreting cervical VF studies.
  • To determine if radiologist experience and training impact agreement on motion findings (normal, hypomobile, hypermobile).

Main Methods:

  • Ten board-certified chiropractic radiologists reviewed 10 cervical VF studies from patients with CAD trauma and asymptomatic volunteers.
  • Participants classified motion as normal, hypomobile, or unable to determine for each cervical segment (OCC/C1-C7/T1).

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  • Inter-rater reliability was analyzed using the kappa statistic; demographic data were correlated with findings.

    • Main Results:

    • The study found moderate agreement among radiologists in classifying cervical intersegmental motion from VF studies.
    • Demographic factors such as years in practice and self-assessed proficiency showed some correlation with agreement levels.
    • Specific factors like formal training and volume of studies read annually were explored for their predictive value.

    Conclusions:

    • Radiologist agreement on cervical VF interpretation for intersegmental motion is moderate.
    • Standardized training and interpretation guidelines may be necessary to improve reliability.
    • Further research could explore specific training methods to enhance diagnostic concordance.