RADIOGRAPHIC SENSITIVITY AND NEGATIVE PREDICTIVE VALUE FOR ACUTE CANINE SPINAL TRAUMA

The objectives of this study were to establish the sensitivity and negative predictive value of radiography for acute spinal osseous lesions in the canine trauma patient, and to evaluate the interobserver variability in radiographic assessment of the spine in traumatized dogs. This was a retrospective multiple observer blinded study. The study population included 30 canine patients that presented following acute trauma, with clinical signs attributable to the spinal column. Radiography and computed tomography (CT) were performed in all cases. Radiographic interpretation was performed independently by four observers with different experience levels who were blinded to clinical information (other than trauma) and the CT results. CT studies were interpreted by a further three radiologists who formed a consensus opinion on the presence of specific osseous lesions. Using the CT results as a gold standard, the sensitivities and negative predictive values of radiography for specific osseous lesions were calculated. Interobserver agreement was also evaluated. Radiography was found to have only a moderate sensitivity for fractures (72%) and subluxations (77.5%). Low negative predictive values were found for the presence of vertebral canal narrowing (58%) and fracture fragments within the vertebral canal (51%). Interobserver agreement was only moderate to fair for most lesion types. In conclusion, radiography cannot be used to reliably rule out potentially unstable acute vertebral lesions in the canine trauma patient, and further imaging is therefore often indicated in the patient with a high risk of such injuries.