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Research ArticleArticle
Open Access

Inter- and Intra-Observer Reliability of Measurement of Pedicle Screw Breach Assessed by Postoperative CT Scans

William F. Lavelle, Ashish Ranade, Amer F. Samdani, John P. Gaughan, Linda P. D'Andrea and Randal R. Betz
International Journal of Spine Surgery January 2014, 8 11; DOI: https://doi.org/10.14444/1011
William F. Lavelle
1Department of Orthopaedic Surgery, State University of New York Upstate Medical University, Syracuse, NY
MD
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Ashish Ranade
2Department of Orthopaedics, SKN Medical College & Hospital, Deenanath Mangeshkar Hospital, Pune, India
MD
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Amer F. Samdani
3Shriners Hospitals for Children—Philadelphia, Philadelphia, PA
MD
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John P. Gaughan
4Biostatistics Consulting Center, Temple University School of Medicine, Philadelphia, PA
PhD
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Linda P. D'Andrea
5Brandywine Institute of Orthopaedics, Pottstown, PA
MD
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Randal R. Betz
6Institute for Spine & Scoliosis, Lawrenceville, NJ
MD
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Article Figures & Data

Figures

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    Figure 1

    Example demonstrating a less than 2 mm breach representative of best agreement.

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    Figure 2

    Example demonstrating a greater than 2 mm breach representative of worst agreement.

Tables

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    Table 1

    Distribution of Screws.

    # of patients# of screws
    Total23286
    Titanium1193
    Stainless steel12193
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    Table 2

    Reliability of CT Reading by Diagnosis.

    Diagnosis# of patients# of screwsInter-observer ICC (UCL-LCL)Intra-observer ICC (UCL-LCL)
    Degenerative151280.21 (0.44-0.05)0.26 (0.50-0.07)
    Deformity81340.38 (0.61-0.18)0.41 (0.63-0.21)
    • ICC = Intraclass correlation coefficient; UCL = 95% upper confidence limit; LCL = 95% lower confidence limit. Only 262/286 screws were available for evaluating the effect of diagnosis on Inter- and Intrarater ICC.

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    Table 3

    Reliability of CT Reading: Titanium Versus Stainless Steel.

    Type of screw# of patients# of screwsInter-observer ICC (UCL-LCL)Intra-observer ICC (UCL-LCL)
    Titanium11930.306 (0.58-0.16)0.36 (0.58-0.16)
    Stainless steel121930.34 (0.58-0.14)0.40 (0.63-0.19)
    • ICC = Intraclass correlation coefficient; UCL = 95% upper confidence limit; LCL = 95% lower confidence limit. All 286 screws were available for this comparison.

    • View popup
    Table 4

    Effect of Age on Reliability of CT Read

    Age# of patients# of screwsInter-observer ICC (UCL-LCL)Intra-observer ICC (UCL-LCL)
    <18 years121560.24 (0.51-0.04)0.25 (0.51-0.39)
    18-60 years4530.37 (0.58-0.17)0.61 (0.60-0.19)
    >60 years7520.16 (0.42-0.39)0.19 (0.47-0.45)
    • ICC = Intraclass correlation coefficient; UCL = 95% upper confidence limit; LCL = 95% lower confidence limit; 261 of 286 screws were available for studying the effect of age on the inter- and intrarater ICC.

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International Journal of Spine Surgery
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1 Jan 2014
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Inter- and Intra-Observer Reliability of Measurement of Pedicle Screw Breach Assessed by Postoperative CT Scans
William F. Lavelle, Ashish Ranade, Amer F. Samdani, John P. Gaughan, Linda P. D'Andrea, Randal R. Betz
International Journal of Spine Surgery Jan 2014, 8 11; DOI: 10.14444/1011

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Inter- and Intra-Observer Reliability of Measurement of Pedicle Screw Breach Assessed by Postoperative CT Scans
William F. Lavelle, Ashish Ranade, Amer F. Samdani, John P. Gaughan, Linda P. D'Andrea, Randal R. Betz
International Journal of Spine Surgery Jan 2014, 8 11; DOI: 10.14444/1011
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Keywords

  • inter/intra observer reliability
  • CT imaging
  • pedicle screw breach

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