Document Detail

Assessment of sacral doming in lumbosacral spondylolisthesis.
MedLine Citation:
PMID:  17762298     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: Quantitative versus subjective evaluation of sacral doming in lumbosacral spondylolisthesis. OBJECTIVES: To evaluate the relevance of the Spinal Deformity Study Group (SDSG) index in the assessment of sacral doming and to propose a quantitative criterion to differentiate between significant and nonsignificant doming. SUMMARY OF BACKGROUND DATA: There is no consensus on the optimal technique to assess sacral doming, although it is an important feature in spondylolisthesis. METHODS: Five spinal surgeons subjectively assessed the sacral endplate of 100 subjects (34 high-grade spondylolisthesis, 50 low-grade spondylolisthesis, 16 controls) from lateral radiographs. Subjects were classified by each surgeon as having significant or nonsignificant sacral doming. An independent observer quantitatively evaluated sacral doming for all subjects using the SDSG index. A criterion to differentiate significant from nonsignificant sacral doming was sought, based on the comparison between the subjective assessment of surgeons and the quantitative evaluation by the independent observer. Intrarater and interrater reliability of the SDSG index was evaluated using intraclass correlation coefficient (ICC). RESULTS: Intrarater and interrater ICCs for the SDSG index were excellent at 0.91 and 0.88, respectively. Sacral doming evaluated with the SDSG index was 11.6% +/- 5.0% (range, 1.5%-18.9%), 16.4% +/- 6.3% (range, 3.7%-35.6%), and 27.9% +/- 10.9% (range, 5.7%-56.9%) for controls, low-grade, and high-grade cases, respectively. Overall intersurgeon agreement on the significance of sacral doming was substantial at 88% (kappa = 0.72). With a threshold value of 25% for the SDSG index, 93% of concordance was found between the quantitative evaluation using the SDSG index and the multisurgeons subjective assessment. CONCLUSION: This study confirms the relevance of the SDSG index to assess sacral doming in lumbosacral spondylolisthesis. The authors propose a criterion of 25% to differentiate significant from nonsignificant sacral doming using the SDSG index. Such a criterion will allow more accurate assessment of sacral remodeling, especially for borderline cases, and facilitate comparisons between studies.
Jean-Marc Mac-Thiong; Hubert Labelle; Stefan Parent; Benoit Poitras; Alain Jodoin; Jean Ouellet; Luc Duong
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  32     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-31     Completed Date:  2007-10-02     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1888-95     Citation Subset:  IM    
Division of Orthopedic Surgery, CHU Sainte-Justine, Montreal, Quebec, Canada.
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MeSH Terms
Lumbosacral Region
Observer Variation
Practice Guidelines as Topic
Radiographic Image Interpretation, Computer-Assisted
Reproducibility of Results
Sacrum / radiography*
Severity of Illness Index
Spondylolisthesis / radiography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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