The Diagnostic Value of an X-ray-based Scoring System for Degeneration of the Cervical Spine: A Reproducibility and Validation Study

M. van Eerd*, J. Patijn, D. Loeffen, M. van Kleef, J. Wildberger

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background In interventional pain medicine, cervical facet joint (CFJ) pain is commonly treated with CFJ denervation techniques, almost automatically assuming degeneration of the CFJs as an important cause of CFJ pain. A standard cervical X-ray is still commonly used in the clinical evaluation of patients suspected for CFJ degeneration. Although degenerative features can be visualized by different radiological imaging techniques, the relation between radiological degenerative features of the cervical spine and pain remains controversial. Paramount in order to estimate the clinical usefulness of a radiological imaging is to establish the reproducibility of the radiological scoring system. A reproducible and clinically feasible diagnostic scoring system was developed to estimate cervical degeneration on standard cervical X-rays.Materials and Methods A reproducibility study for the interpretation of degenerative abnormalities on standard cervical X-rays was performed, using a dichotomous outcome (degenerative abnormalities present Yes/No). The estimation of intervertebral disc height loss on standard cervical X-rays was validated with computed tomography (CT) scan measurements.Results Five radiological degenerative features on standard cervical X-rays (disc height loss, anterior vertebral osteophytes, posterior vertebral osteophytes, vertebral end plate sclerosis, and uncovertebral osteoarthritis) showed a substantial to excellent reproducibility (kappa value >= 0.60). The qualitative definition of disc height loss used in the reproducibility study showed a substantial agreement with the actual measurements of disc height loss on CT scan (kappa value = 0.69).Conclusion Subjective judgment of a cervical standard X-ray is a reproducible method to demonstrate degenerative abnormalities of the cervical spine.
Original languageEnglish
Pages (from-to)766-777
Number of pages12
JournalPain Practice
Volume21
Issue number7
Early online date2021
DOIs
Publication statusPublished - Sept 2021

Keywords

  • cervical pain
  • diagnosis
  • facet joint
  • X&#8208
  • ray
  • DISC DEGENERATION
  • FACET JOINTS
  • RADIOLOGICAL ASSESSMENT
  • LUMBAR SPINE
  • PAIN
  • AGREEMENT
  • OSTEOARTHRITIS
  • COEFFICIENT
  • STATISTICS
  • PROTOCOL

Fingerprint

Dive into the research topics of 'The Diagnostic Value of an X-ray-based Scoring System for Degeneration of the Cervical Spine: A Reproducibility and Validation Study'. Together they form a unique fingerprint.

Cite this