Reproducibility and reliability analysis of French and CARDS classification in degenerative spondylolisthesis

English Keywords:Degenerative spondylolisthesis  French classification  CARDS classification  Reliability  Repeatability

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.