LAUSR

BACKGROUND Vertebral bone quality had a significant impact on postoperative outcomes in spinal fusion surgery. New MRI-based measures, such as the Vertebral Bone Quality (VBQ) score may allow for bone quality assessment without the radiation associated with conventional testing. In the present study, we sought to assess the intra- and interrater reliability of VBQ scores calculated by medical professionals and trainees. METHODS Thirteen reviewers of various specialties and levels of training were recruited and asked to calculate VBQ scores for 30 patients at two time points separated by 2-months. Scored volumes were acquired from patients treated for both degenerative and oncologic indications. Intra-rater and interrater agreement, quantified by intraclass correlation coefficient (ICC), was assessed using two-way random effects modeling. Square-weight Cohen's κ and Kendall's Tau-b were used to determine whether raters assigned similar scores during both evaluations. RESULTS All raters showed moderate to excellent reliability for VBQ score (ICC 0.667-0.957; κ0.648-0.921) and excellent reliability for all constituent components used to calculate VBQ score (ICC all ≥0.97). Interrater reliability was also found to be good for VBQ score on both the first (ICC=0.818) and second (ICC=0.800) rounds of assessment; scores for the constituent component all had ICC values ≥0.97 for the constituent components. CONCLUSIONS The VBQ score appears to have both good intra-rater and interrater reliability. Additionally, there appeared to be no correlation between score reliability and level of training. External validation and further investigations of its ability to accurately model bone biomechanical properties are necessary.