title: Intraobserver reproducibility and interobserver reliability of cervical spine measurements.
abstract: Lateral flexion-extension radiographs of 72 patients with Down syndrome were used to assess the interobserver reliability and intraobserver reproducibility of the atlanto-dens interval, Wiesel-Rothman measurement, occiput atlas angle, and Power's ratio in flexion and extension. The radiographs were reviewed by three blinded observers on three different occasions with at least a 1-month interval between assessments. The intraclass correlation coefficient was used to measure the reproducibility of the measurements from a given observer and the reliability between different observers. With the exception of observer one, the atlanto-dens interval had a statistically significant intraobserver agreement compared with any of the other measurements (p < 0.05). The atlanto-dens interval and the Wiesel-Rothman measurements tended to have better correlation between observers, although there was only fair agreement. The agreement, however, was statistically significant (p < 0.05) compared with Power's ratio. The degree of intraobserver reproducibility and interobserver reliability may make it difficult to base treatment protocols on these measurements.
authors.affiliation: Children's National Medical Center, Washington, DC, USA.
authors.forename: C C
authors.initials: CC
authors.lastname: Wellborn
authors.forename: P F
authors.initials: PF
authors.lastname: Sturm
authors.forename: R S
authors.initials: RS
authors.lastname: Hatch
authors.forename: S R
authors.initials: SR
authors.lastname: Bomze
authors.forename: K
authors.initials: K
authors.lastname: Jablonski
mesh_terms: D000293:Adolescent; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D004314:Down Syndrome / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D015588:Observer Variation; D011859:Radiography; D015203:Reproducibility of Results