Independent inter and intra-observer agreement of the Schizas's classification of degenerative lumbar stenosis: Comparison among three levels of surgical training

• Published in: Revista española de cirugía ortopédica y traumatología 2023-05, Vol.67 (3), p.175-180
• Main Authors: Holc, F., Albani-Forneris, A., Kido, G., Beltrame, S., Petracchi, M., Gruenberg, M., Sola, C., Camino-Willhuber, G.
• Format: Article
• Language: English
• Subjects: Acuerdo independiente; Clasificación de Schizas; Estenosis espinal lumbar; Independent agreement; Lumbar spinal stenosis; Schizas's classification
• ISSN: 1888-4415; 1988-8856
• DOI: 10.1016/j.recot.2022.10.003

Lumbar spinal stenosis is a common age-related condition that affects the quality of life. Multiple classifications have been developed to quantify the severity of stenosis affecting comparison between studies and homogenous communication among surgeons and researchers. Even though this classification has not shown a direct clinical correlation, Schizas's classification appears to be a simple method to assess stenosis. Our objective was to evaluate the inter and intraobserver independent agreement of the Schizas's classification to assess stenosis severity. Additionally, we aimed to compare agreement among three levels of training in spine surgery. An independent inter and intra observer agreement was conducted among junior, senior orthopedic residents and attending spine surgeons. Ninety lumbar levels from 30 patients were evaluated by 16 observers. Weighted kappa agreement was used. Overall interobserver and intraobserver agreement was of 0.57 (95% CI=0.52–0.63) and 0.69 (0.55–0.79), respectively. Interobserver agreement according to level of training yielded values of 0.53 (0.46–0.60) for junior residents, 0.61 (0.54–0.67) for senior residents and 0.67 (0.59–0.74) for attendings. Intraobserver agreement was of 0.54 (0.48–0.60) for junior, 0.60 (0.55–0.66) for senior and 0.66 (0.60–0.72) for attendings. The Schizas's classification showed moderate interobserver and substantial intraobserver agreement. Among attending surgeons, substantial inter and intraobserver agreement was observed. The classification allowed acceptable communication among trained spine surgeons. La estenosis espinal lumbar es una condición frecuente relacionada con la edad que afecta la calidad de vida. Se han desarrollado múltiples clasificaciones para cuantificar la gravedad de la estenosis que afectan la comparación entre estudios y la comunicación homogénea entre cirujanos e investigadores. A pesar de que esta clasificación no ha mostrado una correlación directa con la clínica, la clasificación de Schizas parece ser un método simple para evaluar la estenosis. Nuestro objetivo fue evaluar el acuerdo independiente inter e intraobservador de la clasificación de Schizas en la severidad de la estenosis. Además, comparamos la concordancia entre tres niveles de formación en cirugía de columna. Se llevó a cabo un acuerdo independiente inter e intraobservador entre los residentes ortopédicos principiantes, avanzados y los cirujanos de columna; 90 niveles lumbares de 30 pacientes fueron ev