Background: Upper extremity radicular pain is commonly treated with a cervical transforaminal epidural steroid injection (CTFESI). Recently, a new technique, the modified approach CTFESI, has been developed with a theoretical safety advantage to avoid the neurovascular structures. This approach requires an angle measurement of the superior articular process (SAP) on MRI. The inter-rater reliability of this angle measurement among practicing physicians is yet to be investigated.

Objective: The purpose of this study was to determine the inter-rater reliability of SAP angle measurements on MRI.

Methods: Three raters independently measured the SAP angle on 50 cervical MRIs. A two-way, mixed effects, absolute agreement, single rater statistical model was used to determine the intraclass correlation coefficient (ICC) between all three raters, as well as between each pair of raters.

Results: Inter-rater reliability among all raters showed good reliability with an ICC ​= ​0.837709 (95% CI 0.75-0.9, p ​< ​0.001). Similarly, good inter-rater reliability was found between each of the pairs of raters.

Conclusion: This study demonstrates good inter-rater reliability of MRI SAP angle measurement among clinicians for use in the modified CTFESI approach.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11372974PMC
http://dx.doi.org/10.1016/j.inpm.2023.100176DOI Listing

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