Medical student University at Buffalo Neurosurgery (UBNS)
Introduction: Accurate measurement of spinal parameters is essential for diagnosing and managing spinal disorders. This study compares measurements taken by a senior resident, an experienced operator, and a medical student trained in spinal radiographic parameter measurement. The interrater reliability between the two operators across various spinal parameters was assessed.
Methods: A total of 200 spinal radiographs were selected for analysis. The senior resident was experienced in spine surgery and radiographic measurement, the medical student was trained during 10 hours in spinal radiographic parameter measurement. Each operator independently took measurements, and interrater reliability was assessed using interclass correlation. Parameters analyzed included kyphosis and lordosis across different spinal regions, pelvic incidence-lumbar lordosis (PI-LL), pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), sagittal vertical axis (SVA), C7 coronal sagittal level (C7 CSL), thoracic Cobb angle, and lumbar Cobb angle.
Results: Our analysis revealed varying levels of interrater reliability between the experienced and new operators. Parameters such as lordosis L4-S1 and lordosis L1-S1 exhibited relatively high interrater reliability, with values of 0.67 and 0.55, respectively. Additionally, pelvic parameters, including pelvic incidence-lumbar lordosis (PI-LL) and pelvic incidence (PI), demonstrated moderate to high interrater reliability, with values of 0.54 and 0.73, respectively. Sacral slope (SS), pelvic tilt (PT), and sagittal vertical axis (SVA) also showed relatively high interrater reliability, with values of 0.75, 0.84, and 0.89, respectively. However, parameters related to coronal alignment, such as C7 coronal sagittal level (C7 CSL), exhibited moderate interrater reliability, with a value of 0.61.
Conclusion : Training medical students in spinal radiographic parameter measurement is critical for enhancing research productivity and preparing future spine neurosurgeons. However, challenges persist in achieving consistent measurements, particularly in parameters related to coronal alignment. Further refinement of measurement techniques and training methods may be necessary to improve interrater reliability in these areas.