Comparative intra‑ and inter‑observer reliability of two methods for evaluating intraoperative ultrasonography‑based spinal cord hyperechogenicity intensity in degenerative cervical myelopathy

This study evaluates the reliability of two methods (GVR-A and GVR-B) for measuring spinal cord hyperechogenicity using intraoperative ultrasound (IOUS) in patients with degenerative cervical myelopathy (DCM). The goal was to find a more reliable method for assessing spinal cord changes during surgery. The study involved measuring gray values from ultrasound images of the spinal cord and calculating gray value ratios (GVRs) using two different formulas. The consistency of these measurements was then compared between different observers (inter-observer reliability) and within the same observer at different times (intra-observer reliability). The researchers found that one method (GVR-B), which uses the dural sac as a reference point, had better inter- and intra-observer reliability than the other method (GVR-A). This suggests that GVR-B is a more consistent and reliable way to evaluate spinal cord hyperechogenicity during surgery for DCM.

• 1
  GVR-B has better repeatability of gray value measurement, smaller relative standard deviation (RSD%) compared with GVR-A.
• 2
  The intraobserver reliability was classified as ‘‘moderate agreement’’ for GVR-A and good for GVR-B.
• 3
  For GVR-B, interobserver reliability was classified as ‘‘substantial to almost perfect agreement’’.