Accuracy and repeatability of quantitative fluoroscopy for the measurement of sagittal plane translation and finite centre of rotation in the lumbar spine

Breen, Alexander

doi:10.1016/j.medengphy.2016.03.009

Cited by 16 publications

(14 citation statements)

References 44 publications

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“…Unfortunately, it is prone to large errors for small rotations, making it difficult to gather large amounts of change data over time. However, for rotations greater than 5°, QF has substantial-to-excellent reliability (ICCintra 0.63-0.99 and ICCinter 0.62-0.88) [26].…”

Section: Variables Under Considerationmentioning

confidence: 99%

“…Note that the maximum IV-RoM does not necessarily occur at the maximum of motion frame range Sagittal translation Translation can be calculated for the sagittal plane in vertebral body units (VBU) which are converted to millimetres for presentation by multiplying the result by 35, being the standard chosen for vertebral body depth in millimetres [34]. Intra-and interobserver agreement for translation using QF has been found to be 1.1 mm or less (SEM) with fair-to-substantial reliability (ICCintra 0.53-0.99, ICCinter 0.57-0.93) [35].…”

Section: Variables Under Considerationmentioning

confidence: 99%

“…The resulting studies have provided early evidence that excessive intervertebral sagittal plane translation [20,21], laxity [4], motion sharing inequality (MSI) [5], motion sharing variability (MSV) [22] and instant centres of rotation (ICRs) [23] are in various ways associated with spinal pain. Accuracy and observer repeatability studies have tended to support these parameters, as well as intervertebral range of angular motion (IV-RoM) and anterior disc height [24][25][26]. However, intrasubject repeatability data are lacking.…”

Section: Introductionmentioning

confidence: 99%

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Intrasubject repeatability of in vivo intervertebral motion parameters using quantitative fluoroscopy

2018

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Purpose In vivo quantification of intervertebral motion through imaging has progressed to a point where biomarkers for low back pain are emerging. This makes possible deeper study of the condition's biometrics. However, the measurement of change over time involves error. The purpose of this prospective investigation is to determine the intrasubject repeatability of six in vivo intervertebral motion parameters using quantitative fluoroscopy. Methods Intrasubject reliability (ICC) and minimal detectable change (MDC) of baseline to 6-week follow-up measurements were calculated for six lumbar spine intervertebral motion parameters in 109 healthy volunteers. A standardised quantitative fluoroscopy (QF) protocol was used to provide measurements in the coronal and sagittal planes using both passive recumbent and active weight-bearing motion. Parameters were: intervertebral range of motion (IV-RoM), laxity, motion sharing inequality (MSI), motion sharing variability (MSV), flexion translation and anterior disc height change during flexion. Results The best overall intrasubject reliability (ICC) and agreement (MDC) were for disc height (ICC 0.89, MDC 43%) and IV-RoM (ICC 0.96, MDC 60%), and the worst for MSV (ICC 0.04, MDC 408%). Laxity, MSI and translation had acceptable reliability (most ICCs > 0.60), but not agreement (MDC > 85%). Conclusion Disc height and IV-RoM measurement using QF could be considered for randomised trials, while laxity, MSI and translation could be considered for moderators, correlates or mediators of patient-reported outcomes. MSV had both poor reliability and agreement over 6 weeks. Graphical abstract These slides can be retrieved under Electronic Supplementary Material.

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Section: Variables Under Considerationmentioning

confidence: 99%

Section: Variables Under Considerationmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Intrasubject repeatability of in vivo intervertebral motion parameters using quantitative fluoroscopy

2018

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“…Fluoroscopic systems could potentially make this more powerful by providing continuous joint centre analysis as represented by centrode lengths (another reflection of consistency) without high radiation exposure. However, if a spinal motion segment rotates very little, no measurement of a centre of rotation is possible, due to computational error amplification, which is a limitation of this measure (10).…”

Section: Making Correctionsmentioning

confidence: 99%

Anti-directional cervical intervertebral motion: could it have gone any other way?

Breen¹

2018

J Spine Surg

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“…Although the repeatability and accuracy of the measurement of individual level angular motion have been established and the intrasubject repeatability (or measurement error) of the multiple level measures of MSI and MSV has recently been determined, the analytical intra- and inter-investigator errors remain unknown [ 7 – 10 ]. However, the instrument error has been previously addressed [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Investigator analytic repeatability of two new intervertebral motion biomarkers for chronic, nonspecific low back pain in a cohort of healthy controls

Breen

Mior

et al. 2020

Chiropr Man Therap

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Background Understanding the mechanisms underlying chronic, nonspecific low back pain (CNSLBP) is essential to advance personalized care and identify the most appropriate intervention. Recently, two intervertebral motion biomarkers termed “Motion Sharing Inequality” (MSI) and “Motion Sharing Variability” (MSV) have been identified for CNSLBP using quantitative fluoroscopy (QF). The aim of this study was to conduct intra- and inter-investigator analytic repeatability studies to determine the extent to which investigator error affects their measurement in clinical studies. Methods A cross-sectional cohort study was conducted using the image sequences of 30 healthy controls who received QF screening during passive recumbent flexion motion. Two independent investigators analysed the image sequences for MSI and MSV from October to November 2018. Intra and inter- investigator repeatability studies were performed using intraclass correlations (ICC), standard errors of measurement (SEM) and minimal differences (MD). Results Intra-investigator ICCs were 0.90 (0.81,0.95) (SEM 0.029) and 0.78 (0.59,0.89) (SEM 0.020) for MSI and MSV, respectively. Inter-investigator ICCs 0.93 (0.86,0.97) (SEM 0.024) and 0.55 (0.24,0.75) (SEM 0.024). SEMs for MSI and MSV were approximately 10 and 30% of their group means respectively. The MDs for MSI for intra- and inter-investigator repeatability were 0.079 and 0.067, respectively and for MSV 0.055 and 0.067. Conclusions MSI demonstrated substantial intra- and inter-investigator repeatability, suggesting that investigator input has a minimal influence on its measurement. MSV demonstrated moderate intra-investigator reliability and fair inter-investigator repeatability. Confirmation in patients with CNSLBP is now required.

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Accuracy and repeatability of quantitative fluoroscopy for the measurement of sagittal plane translation and finite centre of rotation in the lumbar spine

Cited by 16 publications

References 44 publications

Intrasubject repeatability of in vivo intervertebral motion parameters using quantitative fluoroscopy

Intrasubject repeatability of in vivo intervertebral motion parameters using quantitative fluoroscopy

Anti-directional cervical intervertebral motion: could it have gone any other way?

Investigator analytic repeatability of two new intervertebral motion biomarkers for chronic, nonspecific low back pain in a cohort of healthy controls

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