An Independent Inter-observer Reliability and Intra-observer Reproducibility Evaluation of SINS Scoring and Kostuik Classification Systems for Spinal Tumor

Abstract Objective Most patients with spinal tumors suffer no symptoms or mild symptoms, but about 14% of patients have refractory pain caused by mechanical instability, or symptoms of spinal cord damage caused by epidural spinal cord compression. SINS and Kostuik classification are commonly used to evaluate the spinal stability, and help to make a more detailed operation plan. The objectives of this study are to evaluate the reliability and reproducibility of SINS and Kostuik classification, and to explore their clinical application value. Methods All 80 patients with spinal tumors were enrolled. 6 spine surgeons who have certain clinical experience were selected. They scored according to SINS scoring system and determined the classification according to Kostuik system, we use Fless’s and Cohen’s k value to check the coefficient consistency for multi-factor. We use Cohen’s k value to check the inter-observer reliability and intra-observer reproducibility. After 12 weeks, we repeated the analysis. Results The inter-observer reliability and intra-observer reproducibility of SINS scoring system were near perfect with values of 0.831 and 0.874. The inter-observer reliability and intra-observer reproducibility of Kostuik classification system were moderate with values of 0.505 and 0.595. Conclusion Compared with Kostuik classification system, SINS scoring system has better inter-observer reliability and intra-observer reproducibility, which can be widely used in clinical practice, and it has great significance in the decision-making of spinal tumor treatment; Although Kostuik classification system is often used in clinical practice, it shows inferior reliability and reproducibility in our study.