Rodrigo Navarro-Ramirez1, Connor Berlin2, Gernot Lang1, Ibrahim Hussain1, Insa Janssen3, Stephen Sloan1, Gulce Askin4, Mauricio J Avila1, Micaella Zubkov1, Roger Härtl5. 1. Brain and Spine Center, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA. 2. Brain and Spine Center, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA; SUNY Downstate College of Medicine, Brooklyn, New York, USA. 3. Department of Neurosurgery, Klinikum rechts der Isar, Technical University Munich, Munich, Germany. 4. Department Statistics, Clinical and Translational Science Center at Weill Cornell Medicine, New York, New York, USA. 5. Brain and Spine Center, New York-Presbyterian Hospital, Weill Cornell Medicine, New York, New York, USA. Electronic address: roh9005@med.cornell.edu.
Abstract
BACKGROUND: Two-dimensional radiographic methods have been proposed to evaluate the radiographic outcome after indirect decompression through extreme lateral interbody fusion (XLIF). However, the assessment of neural decompression in a single plane may underestimate the effect of indirect decompression on central canal and foraminal volumes. The present study aimed to assess the reliability and consistency of a novel 3-dimensional radiographic method that assesses neural decompression by volumetric analysis using a new generation of intraoperative fan-beam computed tomography scanner in patients undergoing XLIF. METHODS: Prospectively collected data from 7 patients (9 levels) undergoing XLIF was retrospectively analyzed. Three independent, blind raters using imaging analysis software performed volumetric measurements pre- and postoperatively to determine central canal and foraminal volumes. Intrarater and Interrater reliability tests were performed to assess the reliability of this novel volumetric method. RESULTS: The interrater reliability between the three raters ranged from 0.800 to 0.952, P < 0.0001. The test-retest analysis on a randomly selected subset of three patients showed good to excellent internal reliability (range of 0.78-1.00) for all 3 raters. There was a significant increase in mean volume ≈20% for right foramen, left foramen, and central canal volumes postoperatively (P = 0.0472; P = 0.0066; P = 0.0003, respectively). CONCLUSIONS: Here we demonstrate a new volumetric analysis technique that is feasible, reliable, and reproducible amongst independent raters for central canal and foraminal volumes in the lumbar spine using an intraoperative computed tomography scanner.
BACKGROUND: Two-dimensional radiographic methods have been proposed to evaluate the radiographic outcome after indirect decompression through extreme lateral interbody fusion (XLIF). However, the assessment of neural decompression in a single plane may underestimate the effect of indirect decompression on central canal and foraminal volumes. The present study aimed to assess the reliability and consistency of a novel 3-dimensional radiographic method that assesses neural decompression by volumetric analysis using a new generation of intraoperative fan-beam computed tomography scanner in patients undergoing XLIF. METHODS: Prospectively collected data from 7 patients (9 levels) undergoing XLIF was retrospectively analyzed. Three independent, blind raters using imaging analysis software performed volumetric measurements pre- and postoperatively to determine central canal and foraminal volumes. Intrarater and Interrater reliability tests were performed to assess the reliability of this novel volumetric method. RESULTS: The interrater reliability between the three raters ranged from 0.800 to 0.952, P < 0.0001. The test-retest analysis on a randomly selected subset of three patients showed good to excellent internal reliability (range of 0.78-1.00) for all 3 raters. There was a significant increase in mean volume ≈20% for right foramen, left foramen, and central canal volumes postoperatively (P = 0.0472; P = 0.0066; P = 0.0003, respectively). CONCLUSIONS: Here we demonstrate a new volumetric analysis technique that is feasible, reliable, and reproducible amongst independent raters for central canal and foraminal volumes in the lumbar spine using an intraoperative computed tomography scanner.
Authors: Gernot Lang; Marco Vicari; Alexander Siller; Eva J Kubosch; Juergen Hennig; Norbert P Südkamp; Kaywan Izadpanah; David Kubosch Journal: Cureus Date: 2018-04-06
Authors: Oded Rabau; Rodrigo Navarro-Ramirez; Mina Aziz; Alisson Teles; Susan Mengxiao Ge; Javier Quillo-Olvera; Jean Ouellet Journal: Global Spine J Date: 2020-05-28
Authors: Peter Endre Eltes; Laszlo Kiss; Ferenc Bereczki; Zsolt Szoverfi; Chloé Techens; Gabor Jakab; Benjamin Hajnal; Peter Pal Varga; Aron Lazary Journal: J Orthop Translat Date: 2021-04-01 Impact factor: 5.191