Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 5618
  Title Inter and intra-examiner reliability of the upper cervical x-ray marking system: A third and expanded look
Journal CRJ. 1994 ;3(1):23-31
Peer Review Yes
Publication Type Article

The purpose of this research is to determine the degree of reliability for four Orthospinology (Grostic) practitioners, by analyzing, reading and rereading 10 sets of upper cervical film. Each set of upper cervical film consisted of a lateral, nasium and vertex view. The reading and rereading were done manually and with computer assisted analysis using the software program "The DOC." Analysis of all measured components of the upper cervical marking procedure was made by using average deviations from the median, standard deviations and the Design I One Way ANOVA for reliability calculations. The analyzed components were: C1 laterality, odontoid, C2 spinous, C1 rotation and lower angle; also analyzed were the measured components for height factor calculations i.e., plane line, condylar surface circle, axial surface circle, the height factor and the S-Line measurement from the lateral film.

Examination of the results suggests the reliability for the atlas laterality, odontoid, C2 spinous, lower angle and height factor measurements are very good. C1 rotation measurements are acceptable. The median of the intra-examiner standard deviations for atlas laterality is 0.45 degrees. This is comparable to the Jackson et al.'s findings of a median atlas standard deviation of 0.41 degrees. This study reveals the atlas laterality can be measured much more accurately than was reported in the Sigler and Howe study which demonstrated 0.82 and 1.10 average difference between readings. The side of atlas laterality (right or left) is in 100% agreement in this study, 120 of 120 readings, indicating consistent patient care. If the deviation of the mean atlas measurement on the post x-ray is greater than 2 standard deviations (0.90 degrees), then there is a 95% probabilit y that the deviation is due to factors other than measurement error, i.e.; C1 position change from the adjustment, pt. placement error, etc.

Author Keywords: Atlas Laterality, Chiropractic X-ray Analysis, Upper Cervical Technique and Grostic Analysis

This abstract is reproduced with the permission of the publisher.


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