Abstract
Purpose
Current standard methods to quantify disc height, namely distortion compensated Roentgen analysis (DCRA), have been mostly utilized in the lumbar and cervical spine and have strict exclusion criteria. Specifically, discs adjacent to a vertebral fracture are excluded from measurement, thus limiting the use of DCRA in studies that include older populations with a high prevalence of vertebral fractures. Thus, we developed and tested a modified DCRA algorithm that does not depend on vertebral shape.
Methods
Participants included 1186 men and women from the Framingham Heart Study Offspring and Third Generation Multidetector CT Study. Lateral CT scout images were used to place 6 morphometry points around each vertebra at 13 vertebral levels in each participant. Disc heights were calculated utilizing these morphometry points using DCRA methodology and our modified version of DCRA, which requires information from fewer morphometry points than the standard DCRA.
Results
Modified DCRA and standard DCRA measures of disc height are highly correlated, with concordance correlation coefficients above 0.999. Both measures demonstrate good inter- and intra-operator reproducibility. 13.9 % of available disc heights were not evaluable or excluded using the standard DCRA algorithm, while only 3.3 % of disc heights were not evaluable using our modified DCRA algorithm.
Conclusions
Using our modified DCRA algorithm, it is not necessary to exclude vertebrae with fracture or other deformity from disc height measurements as in the standard DCRA. Modified DCRA also yields identical measurements to the standard DCRA. Thus, the use of modified DCRA for quantitative assessment of disc height will lead to less missing data without any loss of accuracy, making it a preferred alternative to the current standard methodology.
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Acknowledgments
This study was funded by grants from the National Institutes of Health (R01AG041658, R01AR053986, R01AR41398, and F31AG041629). The Framingham Heart Study is supported by Contract Number HHSN268201500001I from the National Heart, Lung, and Blood Institute (NHLBI) with additional support from other sources. The contents are solely the responsibility of the authors, and do not necessarily represent the views of the NIH, the Framingham Heart Study or the NHLBI.
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Allaire, B.T., DePaolis Kaluza, M.C., Bruno, A.G. et al. Evaluation of a new approach to compute intervertebral disc height measurements from lateral radiographic views of the spine. Eur Spine J 26, 167–172 (2017). https://doi.org/10.1007/s00586-016-4817-5
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DOI: https://doi.org/10.1007/s00586-016-4817-5