Reliability of surgeon-reported MRI findings to a national spine register

Ole Kristian Alhaug; Håvard Furunes; Simran Kaur; Nynne Blomfeldt; Filip C Dolatowski

doi:10.1007/s00701-025-06524-5

Reliability of surgeon-reported MRI findings to a national spine register

Acta Neurochir (Wien). 2025 Apr 14;167(1):105. doi: 10.1007/s00701-025-06524-5.

Authors

Ole Kristian Alhaug^{1

2}, Håvard Furunes^{3

4}, Simran Kaur⁵, Nynne Blomfeldt⁶, Filip C Dolatowski⁷

Affiliations

¹ Orthopaedic Department, Akershus University Hospital, PO Box 1000, N- 1478, Loerenskog, Norway. olekralhaug@hotmail.com.
² The Research Center for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, PO Box 68, N- 2313, Ottestad, Norway. olekralhaug@hotmail.com.
³ Department of Surgery, Innlandet Hospital Trust, Innlandet Hospital Gjøvik, Kyrre Grepps Gate 11, 2819, Gjøvik, Norway.
⁴ Faculty of Medicine, University of Oslo, Oslo, Norway.
⁵ Vestfold Hospital Trust, Tønsberg Sykehus, Halfdan Wilhelmsens Allé 22, 3112, Tønsberg, Norway.
⁶ Orthopaedic Department, Martina Hansens Hospital, Dønskiveien 8, 1346, Gjettum, Norway.
⁷ Orthopaedic Department, Oslo University Hospital, PO Box 4956, N- 0424, Oslo, Norway.

Abstract

Purpose: Spine registries contribute to valuable knowledge and research; however, the data quality has been questioned. MRI findings are crucial for diagnostics and grading of degenerative spinal disorders. We aimed to explore the reliability of surgeon-reported MRI findings in a national spine registry (NORspine).

Methods: We assessed the reliability of MRI findings from three spine centres. Two spine surgeons re-examined previously surgeon-reported MRI findings for a sample of NORspine patients. We assessed the inter-rater reliability and the reliability between the NORspine registry and each study rater by Cohen's Kappa (ƙ).

Results: Two spine surgeons reassessed preoperative MRI of the lumbar spine for 276 previously enrolled NORspine patients; 92 at each treating centre equally distributed by three categories of spinal procedures: removal of disc herniation (LDH), decompression of lumbar spinal stenosis (LSS), and lumbar fusion. The inter-rater reliability varied from fair (0.21) to substantial (0.75) (most reliable for detecting LDH and LSS). The reliability between the NORspine registry and each rater varied from slight (0.13) to substantial (0.75). The highest reliability was found for LDH and LSS (ƙ = 0.72-0.75), while degenerative disc (DDD), foraminal stenosis (FS) and Modic changes had lower reliability (ƙ = 0.27-0.49).

Conclusion: The reliability for surgeon-reported MRI diagnostics to the NORspine registry varied and was substantial for LDH and LSS, moderate for DDD and FS, and slight or fair for Modic changes.

Keywords: Data accuracy; Lumbar disc herniation; Lumbar spinal stenosis; MRI reliability; Modic changes; Spine registry.

MeSH terms

Adult
Aged
Decompression, Surgical
Female
Humans
Intervertebral Disc Degeneration* / diagnostic imaging
Intervertebral Disc Degeneration* / surgery
Intervertebral Disc Displacement* / diagnostic imaging
Intervertebral Disc Displacement* / surgery
Lumbar Vertebrae* / diagnostic imaging
Lumbar Vertebrae* / surgery
Magnetic Resonance Imaging*
Male
Middle Aged
Observer Variation
Registries*
Reproducibility of Results
Spinal Fusion
Spinal Stenosis* / diagnostic imaging
Spinal Stenosis* / surgery
Surgeons*