The Haleem-Marks-Botchu classification: a novel CT-based classification for intracanal rib head penetration.
Spine Deform
; 9(6): 1651-1657, 2021 11.
Article
em En
| MEDLINE
| ID: mdl-34228311
ABSTRACT
PURPOSE:
Intracanal rib head penetration is a well-known entity in dystrophic scoliotic curves in neurofibromatosis type 1. There is potential for spinal cord injury if this is not recognised and managed appropriately. No current CT-based classification system is currently in use to quantify rib head penetration. This article aims to propose and evaluate a novel CT-based classification for rib head penetration primarily for neurofibromatosis but which can also be utilised in other conditions of rib head penetration. MATERIALS ANDMETHODS:
The grading was developed as four grades normal rib head (RH) position-Grade 0, subluxed extracanal RH position-Grade 1, RH at pedicle-Grade 2, intracanal RH-Grade 3. Grade 3 was further classified depending on the head position in the canal divided into thirds. Rib head penetration into proximal third (from ipsilateral side)-Grade 3A, into the middle third-Grade 3B and into the distal third-Grade 3C. Seventy-five axial CT images of Neurofibromatosis Type 1 patients in the paediatric age group were reviewed by a radiologist and a spinal surgeon independently to assess interobserver and intraobserver agreement of the novel CT classification. Agreement analysis was performed using the weighted Kappa statistic.RESULTS:
There was substantial interobserver correlation with mean Kappa score (k = 0.8, 95% CI 0.7-0.9) and near perfect intraobserver Kappa of 1.0 (95% CI 0.9-1.0) and 0.9 (95% CI 0.9-1.0) for the two readers.CONCLUSION:
The novel CT-based classification quantifies rib head penetration which aids in management planning.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Escoliose
/
Neurofibromatose 1
Limite:
Child
/
Humans
Idioma:
En
Revista:
Spine Deform
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Reino Unido