SHENG Yachao,SUN Xu,ZHU Zezhang.Reproducibility and reliability analysis of French and CARDS classification in degenerative spondylolisthesis[J].Chinese Journal of Spine and Spinal Cord,2017,(3):228-234.
Reproducibility and reliability analysis of French and CARDS classification in degenerative spondylolisthesis
Received:January 02, 2017  Revised:March 06, 2017
English Keywords:Degenerative spondylolisthesis  French classification  CARDS classification  Reliability  Repeatability
Fund:南京市临床医学中心资助项目
Author NameAffiliation
SHENG Yachao Department of Orthopeadic, Medical School of Nanjing University, Suqian People′s Hospital of Nanjing Drum Tower Hospital Group, Suqian, 223800, Jiangsu, China 
SUN Xu 南京大学医学院附属南京鼓楼医院脊柱外科 210008 南京市 
ZHU Zezhang 南京大学医学院附属南京鼓楼医院脊柱外科 210008 南京市 
史本龙  
孙伟翔  
陈 曦  
袁鑫鑫  
邱 勇  
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English Abstract:
  【Abstract】 Objectives: To compare the reproducibility and reliability of the French classification and the CARDS classification for degenerative spondylolisthesis(DS), and to compare the clinical values of these two classifications. Methods: One hundred and eighteen L4/5 or L5/S1 DS patients treated surgically from January 2012 to June 2016 were retrospectively analyzed. There were 26 males and 92 females, among whom the average age was 61.1±8.1 years. Three spine surgeons independently and separately measured the preoperative X-rays. The intra-observer reproducibility and inter-observer reliability were analyzed. The Kappa value was calculated to compare the difference between the two classifications. Results: A total of 708 measurements were performed by the 3 surgeons for each classification. In French classification, 261 cases were described as type 1, 107 cases as type 2, 83 cases as type 3, 54 cases as type 4 and 203 cases as type 5. The intra- and inter-observer agreements were 80.5%-86.4%(Kappa value, 0.740-0.815) and 79.7%-82.2%(Kappa value, 0.728-0.758), respectively. The mean time spent on classification for a single case was about 138 seconds. In CARDS classification, 19 cases were classified into type A(A1), 149 cases into type B (90 cases in type B1, 59 cases in type B2), 399 cases into type C(291 cases in type C1, 108 cases in type C2), and 141 cases into type D (98 cases in type D1, 43 cases in type D2). The intra- and inter-observer agreements were 90.7%-93.2% (Kappa value, 0.878-0.911) and 88.1%-94.1% (Kappa value, 0.844-0.921), respectively. The mean time spent on classification for a single case was about 67 seconds. Conclusions: The two classifications have satisfying intra-observer reproducibility and inter-observer reliability for degenerative spondylolisthesis patients. CARDS classification′s reliability and repeatability are better than those of French.
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