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Agreement on the Level Selection in Laminoplasty among Experienced Surgeons: A Survey-Based Study
Asian Spine Journal ; : 663-670, 2016.
Artículo en Inglés | WPRIM | ID: wpr-148232
ABSTRACT
STUDY

DESIGN:

Survey based study.

PURPOSE:

To assess the degree of agreement in level selection of laminoplasty (LP) for the selected cervical myeloradiculopathy cases between experienced spine surgeons. OVERVIEW OF LITERATURE Although, cervical LP is a widely used surgical technique for multi-level spinal cord compression, until now there is no consensus about how many segments or which segments should be opened to achieve a satisfactory decompression.

METHODS:

Thorough clinical and radiographic data (plain X-ray, computed tomography, and magnetic resonance imaging) of 30 patients who had cervical myelopathy were prepared. The data were provided to three independent spine surgeons with over 10 years experience in operation of their own practices. They were questioned about the most preferable surgical method and suitable decompression levels. The second survey was carried out after 6 months with the same cases. If the level difference between respondents was a half level or below, agreement was considered acceptable. The intraobserver and interobserver agreements in level selection were assessed by kappa statistics.

RESULTS:

Three respondents selected LP as an option for 6, 8, and 22 cases in the first survey and 10, 21, and 24 cases in the second survey. The reasons for selection of LP were levels of ossification of the posterior longitudinal ligament (p=0.004), segmental kyphotic deformity (p=0.036) and mean compression score (p=0.041). Intraobserver agreement showed variable results. Interobserver agreement was poor to fair by perfect matching (kappa=0.111–0.304) and fair to moderate by acceptable matching (kappa=0.308–0.625).

CONCLUSIONS:

The degree of agreement for level selection of LP was not high even though experienced surgeons would choose the opening segments on the basis of same criteria. These results suggest that more specific guidelines in determination of levels for LP should be required to decrease unnecessary wide decompression according to individual variance.
Asunto(s)

Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Compresión de la Médula Espinal / Enfermedades de la Médula Espinal / Columna Vertebral / Anomalías Congénitas / Vértebras Cervicales / Encuestas y Cuestionarios / Ligamentos Longitudinales / Descompresión / Consenso / Laminoplastia Tipo de estudio: Guía de Práctica Clínica / Investigación cualitativa Límite: Femenino / Humanos Idioma: Inglés Revista: Asian Spine Journal Año: 2016 Tipo del documento: Artículo

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Texto completo: Disponible Índice: WPRIM (Pacífico Occidental) Asunto principal: Compresión de la Médula Espinal / Enfermedades de la Médula Espinal / Columna Vertebral / Anomalías Congénitas / Vértebras Cervicales / Encuestas y Cuestionarios / Ligamentos Longitudinales / Descompresión / Consenso / Laminoplastia Tipo de estudio: Guía de Práctica Clínica / Investigación cualitativa Límite: Femenino / Humanos Idioma: Inglés Revista: Asian Spine Journal Año: 2016 Tipo del documento: Artículo