Offiah et al. took on a difficult task when they proposed a radiological classification for segmentation defects of the vertebrae (SDV) and then assessed its effectiveness among seven radiologists of various backgrounds. They concluded that their classification and its clinical algorithm did improve the ability of the radiologists to radiologically classify the various SDV. Their efforts have been partially successful and certainly much more accurate and practical than previous classifications. They rightly note that their classification system ''will inevitably evolve as more genotype-phenotype correlations are identified.''
The International Consortium of Vertebral Anomalies and Scoliosis (ICVAS) as represented by Offiah et al. utilized X-rays from 10 ''unseen'' cases and classified them using their algorithm. They gave the 10 cases to seven radiologists without the algorithm for diagnosis and/or description. Almost none of the seven radiologists got the diagnosis and the majority simply stated the ''didn't know.'' The same seven radiologists when given the algorithm improved their diagnostic/categorization skills by almost 66%. It should be noted that 6 of the 10 cases (60%) had been classified by ICVAS as MSDV-RU, which meant that they had no diagnosis for those 6 cases, just a general categorical placement.
The following are some additional observations about the above paper. There is an aspect of a self-fulfilling prophecy in that the seven radiologists were guaranteed to improve since the ICVAS algorithm gave them the descriptions and combination of descriptions to plug into their observations of the radiological features. The authors recognized that the number of cases (10) and X-rays (13) were small and that some of the X-rays were of poor quality and occasionally the full spine was not visible. Additionally, the authors had noted that the existing nomenclature of SDV lacked a molecular component, yet, to my knowledge, none of their 10 cases were stated to have had molecular studies (e.g., DLL3, MESP2, LFNG) known to be associated with SVD. Consequently, they cannot collaborate the genotype-phenotype correlation and/or diagnosis.
Known syndromes such as OAVS and VACTERL are listed under both Multiple (M-SDV) and Single (S-SDV) in the ICVAS algo-