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Grading system for migrated lumbar disc herniation on sagittal magnetic resonance imaging: an agreement study

Authors
Ahn, Y.Jeong, T. S.Lim, T.Jeon, J. Y.
Issue Date
Jan-2018
Publisher
SPRINGER
Keywords
Agreement; Grade; Lumbar; Migrated disc herniation; Magnetic resonance imaging
Citation
NEURORADIOLOGY, v.60, no.1, pp.101 - 107
Journal Title
NEURORADIOLOGY
Volume
60
Number
1
Start Page
101
End Page
107
URI
https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/4189
DOI
10.1007/s00234-017-1943-7
ISSN
0028-3940
Abstract
Migrated lumbar disc herniations (LDHs) in the sagittal plane are common. Disc migration grading can be applied as a useful measurement tool in the diagnosis, treatment, and outcome evaluation of migrated LDH. No study has evaluated the reliability of migrated LDH grading. We evaluated the reliability and functionality of the current magnetic resonance imaging (MRI) grading system for migrated LDH. We assessed a six-level grading system developed based on sagittal MRI and graded according to the direction (rostral and caudal) and degree (low, high, and very high) of disc migration. One-hundred and one migrated LDHs treated with minimally invasive endoscopic discectomy were analyzed independently by two experienced radiologists. Intraobserver and interobserver agreements were assessed by kappa statistics. The most common migrated LDH grade was grade 4 (30.94%; caudal, low-grade migration). Rostral and caudal migrations were more common in the upper and lower lumbar levels, respectively. Interobserver agreement in the grading of migrated LDH was good at both the first (kappa = 0.737) and second assessment (kappa = 0.657). The intraobserver agreement for reader 1 was very good (kappa = 0.827) and for reader 2 was good (kappa = 0.620). The current grading system for migrated LDH was found to be reliable and functional with good interobserver and intraobserver agreement. It may be useful in the interpretation of disc migration patterns and outcomes of various minimally invasive surgical procedures.
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