Open AccessUsing the cobweb classification system as a digital location system for the neurologic compression in cervical degenerative disease
Author(s) -
Xiong Yang,
Yang YingLi,
Yu Xing,
Wang FengXian,
Yang YongDong,
Zhao DingYan,
Zhao He,
Li ChuanHong,
Yang KaiTan
Publication year - 2021
Publication title -
jor spine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2572-1143
DOI - 10.1002/jsp2.1185
Subject(s) - medicine , orthopedic surgery , magnetic resonance imaging , cohen's kappa , compression (physics) , kappa , reliability (semiconductor) , surgery , spinal cord compression , nuclear medicine , radiology , spinal cord , computer science , mathematics , power (physics) , materials science , physics , quantum mechanics , machine learning , psychiatry , composite material , geometry
Abstract Objective To provide the cobweb classification system (CCS) for the precise digital location and description of the neurological compression in cervical degenerative disease (CDD), and the reliability and the clinical subgroup analysis of the system were tested and analyzed. Methods The CCS consisted of three parts: compression zones ( 1 ‐ 12 ), degrees ( a , b ) and ossification ( s , m , h ). Computerized tomography (CT) and magnetic resonance imaging (MRI) images from 238 CDD patients were reviewed. All compression cases were classified by five independent reviewers with varied clinical experience in spine surgery. The reliability of the CCS was tested by calculating the kappa ( κ ) statistics value. Finally, 74 patients with anterior cervical surgery treatment were enrolled for the clinical subgroup analysis. Results For the small compression, including single and double compression zones, there was a good interobserver reliability between the reviewers ( κ coefficient = .855, P < .001). For the large compression with three or more involved zones, there was a fair reliability between the reviewers ( κ coefficient = .696, P < .001). The whole intraobserver reliability was good ( κ coefficient = .923, P < .001). For clinical practice, the operative time in the large compression and the m/h group was significantly longer than the small compression and the s group, respectively ( P < .05), and the blood loss in the m/h group was significantly increased as well ( P < .01). Though the preoperative Japanese Orthopedic Association score in Group b was lower than Group a ( P < .05), all patients had achieved significant clinical improvement at last follow‐up. Conclusions The CCS can be used to provide detailed and objective descriptions of the location, extent, and severity of neurological compressions in CDD with satisfactory reliability. Surgeons should pay more attention to the patient with large zone, degree b , and ossification compression, because the operation may be more challenging.