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Erschienen in: European Spine Journal 9/2016

15.02.2016 | Original Article

The Pfirrmann classification of lumbar intervertebral disc degeneration: an independent inter- and intra-observer agreement assessment

verfasst von: Julio Urrutia, Pablo Besa, Mauricio Campos, Pablo Cikutovic, Mario Cabezon, Marcelo Molina, Juan Pablo Cruz

Erschienen in: European Spine Journal | Ausgabe 9/2016

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Abstract

Purpose

Grading inter-vertebral disc degeneration (IDD) is important in the evaluation of many degenerative conditions, including patients with low back pain. Magnetic resonance imaging (MRI) is considered the best imaging instrument to evaluate IDD. The Pfirrmann classification is commonly used to grade IDD; the authors describing this classification showed an adequate agreement using it; however, there has been a paucity of independent agreement studies using this grading system. The aim of this study was to perform an independent inter- and intra-observer agreement study using the Pfirrmann classification.

Methods

T2-weighted sagittal images of 79 patients consecutively studied with lumbar spine MRI were classified using the Pfirrmann grading system by six evaluators (three spine surgeons and three radiologists). After a 6-week interval, the 79 cases were presented to the same evaluators in a random sequence for repeat evaluation. The intra-class correlation coefficient (ICC) and the weighted kappa (wκ) were used to determine the inter- and intra-observer agreement.

Results

The inter-observer agreement was excellent, with an ICC = 0.94 (0.93–0.95) and wκ = 0.83 (0.74–0.91). There were no differences between spine surgeons and radiologists. Likewise, there were no differences in agreement evaluating the different lumbar discs. Most differences among observers were only of one grade. Intra-observer agreement was also excellent with ICC = 0.86 (0.83–0.89) and wκ = 0.89 (0.85–0.93).

Conclusions

In this independent study, the Pfirrmann classification demonstrated an adequate agreement among different observers and by the same observer on separate occasions. Furthermore, it allows communication between radiologists and spine surgeons.
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Metadaten
Titel
The Pfirrmann classification of lumbar intervertebral disc degeneration: an independent inter- and intra-observer agreement assessment
verfasst von
Julio Urrutia
Pablo Besa
Mauricio Campos
Pablo Cikutovic
Mario Cabezon
Marcelo Molina
Juan Pablo Cruz
Publikationsdatum
15.02.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
European Spine Journal / Ausgabe 9/2016
Print ISSN: 0940-6719
Elektronische ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-016-4438-z

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