Artículos de revistas
Intraobserver And Interobserver Reliability Of The Landim's Classification System For Lumbar Spinal Stenosis [avaliacao Intra-observador E Inter-observadores Do Sistema De Classificacao De Landim Para Estenose Vertebral Lombar]
Registro en:
Coluna/ Columna. , v. 8, n. 1, p. 63 - 67, 2009.
18081851
2-s2.0-67650146950
Autor
De Medeiros R.C.
Cardoso I.M.
Jaccard A.P.B.
Landim E.
Pasqualini W.
Veiga I.G.
Neto M.I.R.
Cavali P.T.M.
Institución
Resumen
Objective: the Classification proposed by Landim for lumbar spine stenosis could be a method of diagnostic standardization once, on the literature, there are no studies that standardize the use of a classification which allows the comparison of results. It is necessary the evaluation of intra and interobservers ' reproducibility for such system as to validate it for this matter. Methods:pre-operative image exam of lumbosacral column of 11 patients diagnosed with symptomatic lumbar stenosis were selected. The criteria for selection were image exams with good quality and diverse etiologies. The age group ranged from 15 to 87 years and included both sexes. The studied samples were followed at the Ambulatory of Spine Column of the Department of Orthopaedics and Traumatology of the Hospital das Clínicas, Universidade de Campinas (Unicamp), city of Campinas, state of São Paulo, Brazil. Twelve spine surgeons classified the 11 sample exams according to Landim 's Classification in two different moments with a time interval of 3 weeks. The intra and interobservers ' statistical analysis used were the Wilcoxon and the Alpha of Cronbach Tests, respectively. Significant results were considered as P<0.05. Results: the analysis of the addition of the first and second classifications from the 11 cases appraised by 12 spine surgeons with a time interval of 3 weeks, resulted in percentual accordance among intra and interobserver of 65% and 83% for global classification; 80% and 91% for "segment"; 86% and 95% for "type"; 85% and 82% for "area", respectively. The intraobserver reproducibility was 79% and interobserver, 88%. Conclusion: the proposed Classification of Landim has an easy applicability and may become a possible mean to standardize information with good levels of reproducibility and confidence intra and interobservers for more consistent future conclusions related to the pathology of lumbar stenosis. 8 1 63 67 Arnoldi, C.C., Brodsky, A.E., Cauchoix, J., Crock, H.V., Dommisse, G.F., Edgar, M.A., Lumbar spinal stenosis and nerve root entrapment syndromes: Definition and classification (1976) Clin Orthop Relat Res, 115, pp. 4-5 van Akkerveeken PF. A taxonomy of lumbar stenosis with emphasis on clinical applicability. Eur Spine J. 1994;3(3):130-čKunogi J, Hasue M. Diagnosis and operative treatment of intraforaminal and extraforaminal nerve root compression. Spine. I991;16(ll):1312-20Yamashita, K., Aono, H., Yamasaki, R., Clinical classification of patients with lumbar spinal stenosis based on their leg pain syndrome: Its correlation with 2-year surgical outcome (2007) Spine, 32 (9), pp. 980-985 Amundsen, T., Weber, H., Lilleñs, F., Nordal, H.J., Abdelnoor, M., Magnaes, B., Lumbar spinal stenosis. Clinical and radiologic features (1995) Spine, 20 (10), pp. 1178-1186 Andersson, G.B., McNeill, T.W., (1997) Lumbar spinal stenosis, , Chicago: Mosby; Anderson, G., McNeill, T.W., (2006) Lumbar spinal stenosis, 20. , Amsterdam: Elsevier, Saunders; Landim, E., A new classification for lumbar stenosis (2008) Coluna/Columna, 7 (2), pp. 97-100 Lenke LG, Betz RR, Bridwell KH, Clements DH, Harms J, Lowe TG et al. lntraobserver and interobserver reliability of the classification of thoracic adolescent idiopathic scoliosis. J Bone Joint Surg Am. I998;80(8):1097-106Sato, H., Kikuchi, S., The natural history of radiographic instability of lumbar spine (1993) Spine, 18 (14), pp. 2075-2079 Muggleton, J.M., Kondracki, M., Allen, R., Spinal fusion for lumbar instability: Does it have a scientific basis? (2000) J Spinal Disord, 13 (3), pp. 200-204 Amundsen, T., Weber, H., Nordal, H.J., Magnaes, B., Abdelnoor, M., Lilleâs, F., Lumbar spinal stenosis: Conservative or surgical management?: A prospective 10year study (2000) Spine, 25 (11), pp. 1424-1435. , discussion 1435-6 Turner JA, ErsekM, Herron L, Deyo R. Surgery for lumbar spinal stenosis: Attempted meta-analysis of the literature. Spine 1992;l7(l):l-8deGraaf, I., Prak, A., Bierma-Zeinstra, S., Thomas, S., Peul, W., Koes, B., Diagnosis of lumbar spinal stenosis: A systematic review of the accuracy of diagnostic tests (2006) Spine, 31 (10), pp. 1168-1176 Zhao, F., Pollintine, P., Hole, B.D., Dolan, P., Adams, M.A., Discogenic origins of spinal instability (2005) Spine, 30 (23), pp. 2621-2630 Rihn, J.A., Lee, J.Y., Khan, M., Ulibarri, J.A., Tannoury, C., Donaldson 3rd, W.F., Does lumbar facet fluid detected on magnetic resonance imaging correlate with radiographic instability in patients with degenerative lumbar disease? (2007) Spine, 32 (14), pp. 1555-1560 Ogon, M., Giesinger, K., Behensky, H., Wimmer, C., Nogler, M., Bach, C.M., Interobserver and intraobserver reliability of Lenke's new scoliosis classification system (2002) Spine, 27 (8), pp. 858-862