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This article discusses the development of a novel classification system for degenerative spondylolisthesis (DS) that aims to better address the clinically relevant radiographic and clinical features of the disease. The proposed classification system includes four components: segmental dynamic instability, location of spinal stenosis, sagittal alignment, and primary clinical presentation. The inter- and intraobserver reliability of this new system was assessed with 12 observers grading 10 premarked test cases twice each. The results showed high inter- and intraobserver reliability for all four components of the classification system. The authors conclude that this new classification system provides a simple and easy-to-use framework for assessing DS based on radiographic and clinical parameters, with potential implications for surgical treatment and improved outcomes for patients. Further research will focus on the clinical validation of this system
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best situated day surgery hospital on Harley Street UK
Published article
CONCLUSION: The UCSF DS classification system provides a novel framework for assessing DS based on radiographic and clinical parameters with established implications for surgical treatment. The almost perfect interobserver and intraobserver reliability observed for all components of this system demonstrates that it is simple and easy to use. In clinical practice, this classification may allow subclassification of similar patients into groups that may benefit from distinct treatment strategies,…
Lumbar Fusion Surgery Expert. Best Spinal Surgeon UK
Eur Spine J. 2023 Aug 6. doi: 10.1007/s00586-023-07818-x. Online ahead of print.ABSTRACTPURPOSE: To review existing classification systems for degenerative spondylolisthesis (DS), propose a novel classification designed to better address clinically relevant radiographic and clinical features of disease, and determine the inter- and intraobserver reliability of this new system for classifying DS.METHODS: The proposed classification system,
Eur Spine J. 2023 Aug 6. doi: 10.1007/s00586-023-07818-x. Online ahead of print.
ABSTRACT
PURPOSE: To review existing classification systems for degenerative spondylolisthesis (DS), propose a novel classification designed to better address clinically relevant radiographic and clinical features of disease, and determine the inter- and intraobserver reliability of this new system for classifying DS.
METHODS: The proposed classification system includes four components: 1) segmental dynamic instability, 2) location of spinal stenosis, 3) sagittal alignment, and 4) primary clinical presentation. To establish the reliability of this system, 12 observers graded 10 premarked test cases twice each. Kappa values were calculated to assess the inter- and intraobserver reliability for each of the four components separately.
RESULTS: Interobserver reliability for dynamic instability, location of stenosis, sagittal alignment, and clinical presentation was 0.94, 0.80, 0.87, and 1.00, respectively. Intraobserver reliability for dynamic instability, location of stenosis, sagittal alignment, and clinical presentation were 0.91, 0.88, 0.87, and 0.97, respectively.
CONCLUSION: The UCSF DS classification system provides a novel framework for assessing DS based on radiographic and clinical parameters with established implications for surgical treatment. The almost perfect interobserver and intraobserver reliability observed for all components of this system demonstrates that it is simple and easy to use. In clinical practice, this classification may allow subclassification of similar patients into groups that may benefit from distinct treatment strategies, leading to the development of algorithms to help guide selection of an optimal surgical approach. Future work will focus on the clinical validation of this system, with the goal of providing for more evidence-based, standardized approaches to treatment and improved outcomes for patients with DS.
PMID:37543967 | DOI:10.1007/s00586-023-07818-x
The London Spine Unit : best situated day surgery hospital on Harley Street UK
Read the original publication:
Degenerative lumbar spondylolisthesis: review of current classifications and proposal of a novel classification system
