ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
The Total Disc Replacement Osteolysis Grading Scale - a simple, reliable and quantifiable tool for assessing, managing and reporting osteolysis after cervical total disc replacement.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCervical Total Disc Replacement (CTDR) related periprosthetic osteolysis is inconsistently reported. The purpose of this study is to assess the previously published TDR Osteolysis Grading Scale, a quantitative classification system of CTDR-related osteolysis, and to assess its reliability and utility using Computer Tomography (CT) and X-ray imaging.
methodsParticipants were assigned to Groups A (CT, 20 participants, 27 implants) and B (X-ray, 20 participants, 26 implants). Four blinded raters independently measured osteolytic cysts and both vertebral endplates, calculated the percentage of osteolysis and assigned osteolysis grades: Grade 0, no osteolysis; Grade 1, < 50% of 1 endplate; Grade 2, < 50% of both endplates; Grade 3, ≥ 50% of 1 endplate; Grade 4, ≥ 50% of both endplates. Inter-rater reliability and sensitivity were assessed using intraclass correlation coefficients (ICC), Fleiss' and Cohen's Kappa statistics and sensitivity testing.
resultsGroup A had good reliability for osteolytic cyst measurements (ICC = 0.78-0.79), poor reliability for endplate measurements (ICC = 0.41-0.45) and moderate reliability for osteolysis grades (κ-coefficient = 0.42). Group B had moderate reliability for osteolytic cyst (ICC = 0.55-0.57) and endplate measurements (ICC = 0.55-0.64) and fair reliability for osteolysis grades (κ-coefficient = 0.30). Reliability between reference grades and assigned grades was moderate for Group A (κ-coefficient = 0.46-0.60) and fair for Group B (κ-coefficient = 0.08-0.35). Sensitivity was greater for high grade osteolysis (grade 3 and 4) in Group A (0.80-1) than Group B (0.17-0.50).
conclusionThe TDR Osteolysis Grading Scale demonstrated good reliability and sensitivity amongst raters with CT. Implementing this tool may aid in standardising osteolysis reporting, monitoring osteolysis progression and clinical decision-making.
Indexed as
Identifiers
40745412What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.