Clinical validity of two different grading systems for lumbar central canal stenosis: Schizas and Lee classification systems

To assess the learnability of two magnetic resonance imaging (MRI) grading systems for lumbar central canal stenosis based on inter-observer agreement and test-retest reliability of doctors with no prior knowledge of the two systems. Two clinical fellows, one novice radiology resident, one neurosurg...

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Bibliographic Details
Published in:PloS one 2020-05, Vol.15 (5), p.e0233633-e0233633
Main Authors: Ko, Yeon-Jee, Lee, Eugene, Lee, Joon Woo, Park, Chi Young, Cho, Jungheum, Kang, Yusuhn, Ahn, Joong Mo
Format: Article
Language:English
Subjects:
Back pain
Biology and Life Sciences
Cerebrospinal fluid
Classification
Classification systems
Confidence limits
Diagnosis
Diagnostic imaging
Epidural
Hospitals
Intervertebral discs
Magnetic resonance
Magnetic resonance imaging
Medical research
Medicine and Health Sciences
Methods
Morphology
Observers
Orthopedics
Patients
People and Places
Physical Sciences
Physicians
Radiology
Reliability
Research and Analysis Methods
Resonance
Spinal stenosis
Stenosis
Teachers
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Summary:To assess the learnability of two magnetic resonance imaging (MRI) grading systems for lumbar central canal stenosis based on inter-observer agreement and test-retest reliability of doctors with no prior knowledge of the two systems. Two clinical fellows, one novice radiology resident, one neurosurgeon, and one orthopedic surgeon, who were unaware of the two qualitative MRI grading systems prior to this study, acquainted themselves with the teaching files. All five observers independently assessed the LCCS grade of 70 patients using T2-weighted axial magnetic resonance images at the L2-3, L3-4, L3-4, and L5-S1 disc levels. Analysis was performed twice at an interval of two months. The inter-observer agreement among all five readers was excellent and test-retest reliability was moderate to excellent for both the Schizas and Lee systems. Positive percentage agreements were found to be over 0.8 in almost all observers with relatively narrow 95% confidence limits. Both Schizas and Lee MRI grading systems for LCCS are reliable grading systems, and can be used as a learnable method for both clinicians and radiologists.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0233633