Turkish Neurosurgery
A Retrospective Analysis of Intrathecal Catheter Tip Position in Plain Radiography: How Much Do We Agree?
Georgios Matis1
1Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, Cologne,
DOI: 10.5137/1019-5149.JTN.35332-21.2

Aim:Intrathecal drug delivery systems (IDDS) are an effective treatment for malignant and non-malignant chronic pain. The aim of this study was to assess interrater and intrarater reliability of postoperative plain radiographs, which are routinely performed to confirm the correct placement of the catheter tip after IDDS implantation.Material and Methods:This was a retrospective analysis of plain radiographs obtained from patients implanted with intrathecal catheters and morphine pumps. Each plain radiograph was assessed independently by three raters with varying expertise, at three different time points, to confirm the position of the intrathecal catheter tip. Krippendorff’s alpha coefficient was used to calculate both the interrater and intrarater reliability.Results:There was a high level of agreement among the three raters and the three reviews of each rater separately when assessing the location of intrathecal catheter tips in plain radiographs from 126 patients. This was evidenced by the Krippendorff’s alpha value being >0.99 in all cases, which was greater than the cutoff threshold value of 0.8. Conclusion:The interrater and intrarater reliability of plain radiographs for determination of catheter tip position after IDDS implantation was high. The experience and expertise of the raters did not significantly affect the assessments. Further studies investigating the level of agreement among the raters and the role of individual factors, such as personal skills and educational background, are needed. The development of diagnostic algorithms or tools, to assist physicians and enable a more uniform approach in radiograph evaluation, should be encouraged.

Corresponding author : Georgios Matis