Reliability And Reproducibility Analysis Of Schizas Morphological Classification And Evaluation Of Lumbar Spinal Stenosis

Objective: To investigate the inter-observer reliability and intra-observer reproducibility and efficacy evaluation of MRI Schizas morphological classification of lumbar spinal stenosis and its clinical.Methods: Form January 2014 to December 2015,100 patients with lumbar spinal stenosis were treated in our department.Based on the Schizas classification system,the MRI were assessed by three observers independently on two separate occasions.The inter-observer reliability and intra-observer reproducibility of the system were quantified by using Kappa value.The clinical data were retrospectively analyzed.The differences of ODI,VAS before treatment and at the last follow up,as well as hospitalization time and cost during treatment were analyzed respectively in all patients.There was no significant differences in general data in the patients undergoing conservative and surgical treatment(P>0.05).Results: The total 600 classifications were evaluated for two times.65 cases were described as grade A,200 cases as grade B,219 cases as grade C and 116 cases as grade D.The inter-observer reliability assessed by mean percentage and Kappa values at first time was 86%,0.867 for this classification.The intra-observer reproducibility assessed by mean percentage and Kappa values 93%,0.892 for this classification.There was no significant difference in ODI and VAS scores between the conservative group and the surgical group of grade B patients at the last follow-up(P>0.05),but significant difference in ODI and VAS approached when compared with the counterpart values before treatment(P<0.05).In addition,There was significant difference between two groups in hospitalization time and cost(P<0.05).There was significant difference in ODI and VAS scores between the conservative group and the surgical group of grade C patients at the last follow-up(P<0.05),and significant difference in ODI and VAS approached when compared with the counterpart values beforetreatment(P<0.05).There was significant difference between two groups in hospitalization time and cost(P<0.05).Conclusions:The Schizas morphological for lumbar spinal stenosis has excellent inter-observer reliability and intra-observer reproducibility.Both conservative treatment and surgical treatment can improve the symptoms of lumbar spinal stenosis to some degree.Therefore,Schizas morphology grading has a reference value in the treatment of lumbar spinal stenosis.