Researchers from Ontario, Canada-based The Ottawa Hospital and Boston-based Massachusetts General Hospital investigated the variability in treatment planning for adult spinal deformity by leveraging patients' clinical and radiographic data.
Clinical Spine Surgery published the study, which included 28 adult deformity surgeons. Each surgeon completed an online survey regarding 10 spinal deformity cases, inclusive of a photographs, Oswestry Disability Index and Visual Analog Scale scores as well as imaging with radiographic measurements. Surgeons shared whether they believed surgical management was the correct treatment and their surgical plan, if applicable.
Researchers used average Cohen and Feiss Kappa statistics to measure intraobserver and interobserver reliability.
Here are five takeaways:
1. The study revealed average intrarater and interrater agreement for the surgical strategy were "substantial and fair."
2. After diving into interrater statistic details, the researchers discovered slight agreement on whether surgery was necessary, the surgical approach and whether fusion should be performed.
3. The study found moderate agreement among surgeons for decompression and osteotomy.
4. Researchers concluded surgeon agreement about surgery necessity and strategy for adult spinal deformity is lacking.
5. They recommend developing adult spinal deformity classifications as well as additional studies to create guidelines and reduce variability.