title: Reliability analysis of radiographic methods for determination of posterolateral lumbossacral fusion.
abstract: OBJECTIVE
  To analyze intra and interobserver agreement of two radiographic methods for evaluation of posterolateral lumbar arthrodesis.
  
  
  METHODS
  Twenty patients undergoing instrumented posterolateral fusion were evaluated by anteroposterior and dynamic lateral radiographs in maximal flexion and extension. The images were evaluated initially by 6 orthopedic surgeons, and after 8 weeks, reassessed by 4 of them, totaling 400 radiographic measurements. Intra and interobserver reliability were analyzed using the Kappa coefficient and Landis and Koch criteria.
  
  
  RESULTS
  Intra and interobserver agreement regarding anteroposterior radiographs were, respectively, 76 and 63%. On lateral views, these values were 78 and 84%, respectively. However, the Kappa analysis showed poor intra and interobserver agreement in most cases, regardless of the radiographic method used.
  
  
  CONCLUSIONS
  There was poor intra and interobserver agreement in the evaluation of lumbosacral fusion by plain film in anteroposterior and dynamic lateral views, with no statistical superiority between the methods.
authors.affiliation: Santa Casa da Misericórdia de Santos, Santos, SP, Brazil.
authors.forename: Alberto Ofenhejm
authors.initials: AO
authors.lastname: Gotfryd
authors.affiliation: Santa Casa da Misericórdia de Santos, Santos, SP, Brazil.
authors.forename: Felipe de Moraes
authors.initials: Fde M
authors.lastname: Pomar
authors.affiliation: Santa Casa da Misericórdia de Santos, Santos, SP, Brazil.
authors.forename: Nicola Jorge
authors.initials: NJ
authors.lastname: Carneiro Neto
authors.affiliation: Santa Casa da Misericórdia de Santos, Santos, SP, Brazil.
authors.forename: Fernando José
authors.initials: FJ
authors.lastname: Franzin
authors.affiliation: Faculdade de Medicina do ABC, Santo André, SP, Brazil.
authors.forename: Luciano Miller Reis
authors.initials: LM
authors.lastname: Rodrigues
authors.affiliation: Universidade Federal de São Paulo, Santos, SP, Brazil.
authors.forename: Patricia Rios
authors.initials: PR
authors.lastname: Poletto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D016348:Osseointegration; D013123:Spinal Fusion; D014057:Tomography, X-Ray Computed