Interrater Reliability of the Postoperative Epidural Fibrosis Classification: A Histopathologic Study in the Rat Model
Study DesignAgreement study.PurposeTo validate the interrater reliability of the histopathological classification of the post-laminectomy epidural fibrosis in an animal model.Overview of LiteratureEpidural fibrosis is a common cause of failed back surgery syndrome. Many animal experiments have been...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Spine Society
2015-08-01
|
| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://www.asianspinejournal.org/upload/pdf/asj-9-587.pdf |
| _version_ | 1828814305663909888 |
|---|---|
| author | Surachai Sae-Jung Kitti Jirarattanaphochai Chat Sumananont Kriangkrai Wittayapairoj Kamolsak Sukhonthamarn |
| author_facet | Surachai Sae-Jung Kitti Jirarattanaphochai Chat Sumananont Kriangkrai Wittayapairoj Kamolsak Sukhonthamarn |
| author_sort | Surachai Sae-Jung |
| collection | DOAJ |
| description | Study DesignAgreement study.PurposeTo validate the interrater reliability of the histopathological classification of the post-laminectomy epidural fibrosis in an animal model.Overview of LiteratureEpidural fibrosis is a common cause of failed back surgery syndrome. Many animal experiments have been developed to investigate the prevention of epidural fibrosis. One of the common outcome measurements is the epidural fibrous adherence grading, but the classification has not yet been validated.MethodsFive identical sets of histopathological digital files of L5-L6 laminectomized adult Sprague-Dawley rats, representing various degrees of postoperative epidural fibrous adherence were randomized and evaluated by five independent assessors masked to the study processes. Epidural fibrosis was rated as grade 0 (no fibrosis), grade 1 (thin fibrous band), grade 2 (continuous fibrous adherence for less than two-thirds of the laminectomy area), or grade 3 (large fibrotic tissue for more than two-thirds of the laminectomy area). A statistical analysis was performed.ResultsFour hundred slides were independently evaluated by each assessor. The percent agreement and intraclass correlation coefficient (ICC) between each pair of assessors varied from 73.5% to 81.3% and from 0.81 to 0.86, respectively. The overall ICC was 0.83 (95% confidence interval, 0.81-0.86).ConclusionsThe postoperative epidural fibrosis classification showed almost perfect agreement among the assessors. This classification can be used in research involving the histopathology of postoperative epidural fibrosis; for example, for the development of preventions of postoperative epidural fibrosis or treatment in an animal model. |
| first_indexed | 2024-12-12T10:19:57Z |
| format | Article |
| id | doaj.art-471bb565be984ac7a35100a21c5570ec |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-12-12T10:19:57Z |
| publishDate | 2015-08-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-471bb565be984ac7a35100a21c5570ec2022-12-22T00:27:34ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462015-08-019458759410.4184/asj.2015.9.4.587806Interrater Reliability of the Postoperative Epidural Fibrosis Classification: A Histopathologic Study in the Rat ModelSurachai Sae-Jung0Kitti Jirarattanaphochai1Chat Sumananont2Kriangkrai Wittayapairoj3Kamolsak Sukhonthamarn4Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand.Study DesignAgreement study.PurposeTo validate the interrater reliability of the histopathological classification of the post-laminectomy epidural fibrosis in an animal model.Overview of LiteratureEpidural fibrosis is a common cause of failed back surgery syndrome. Many animal experiments have been developed to investigate the prevention of epidural fibrosis. One of the common outcome measurements is the epidural fibrous adherence grading, but the classification has not yet been validated.MethodsFive identical sets of histopathological digital files of L5-L6 laminectomized adult Sprague-Dawley rats, representing various degrees of postoperative epidural fibrous adherence were randomized and evaluated by five independent assessors masked to the study processes. Epidural fibrosis was rated as grade 0 (no fibrosis), grade 1 (thin fibrous band), grade 2 (continuous fibrous adherence for less than two-thirds of the laminectomy area), or grade 3 (large fibrotic tissue for more than two-thirds of the laminectomy area). A statistical analysis was performed.ResultsFour hundred slides were independently evaluated by each assessor. The percent agreement and intraclass correlation coefficient (ICC) between each pair of assessors varied from 73.5% to 81.3% and from 0.81 to 0.86, respectively. The overall ICC was 0.83 (95% confidence interval, 0.81-0.86).ConclusionsThe postoperative epidural fibrosis classification showed almost perfect agreement among the assessors. This classification can be used in research involving the histopathology of postoperative epidural fibrosis; for example, for the development of preventions of postoperative epidural fibrosis or treatment in an animal model.http://www.asianspinejournal.org/upload/pdf/asj-9-587.pdfFibrosisLaminectomyPathologyPostoperative period |
| spellingShingle | Surachai Sae-Jung Kitti Jirarattanaphochai Chat Sumananont Kriangkrai Wittayapairoj Kamolsak Sukhonthamarn Interrater Reliability of the Postoperative Epidural Fibrosis Classification: A Histopathologic Study in the Rat Model Asian Spine Journal Fibrosis Laminectomy Pathology Postoperative period |
| title | Interrater Reliability of the Postoperative Epidural Fibrosis Classification: A Histopathologic Study in the Rat Model |
| title_full | Interrater Reliability of the Postoperative Epidural Fibrosis Classification: A Histopathologic Study in the Rat Model |
| title_fullStr | Interrater Reliability of the Postoperative Epidural Fibrosis Classification: A Histopathologic Study in the Rat Model |
| title_full_unstemmed | Interrater Reliability of the Postoperative Epidural Fibrosis Classification: A Histopathologic Study in the Rat Model |
| title_short | Interrater Reliability of the Postoperative Epidural Fibrosis Classification: A Histopathologic Study in the Rat Model |
| title_sort | interrater reliability of the postoperative epidural fibrosis classification a histopathologic study in the rat model |
| topic | Fibrosis Laminectomy Pathology Postoperative period |
| url | http://www.asianspinejournal.org/upload/pdf/asj-9-587.pdf |
| work_keys_str_mv | AT surachaisaejung interraterreliabilityofthepostoperativeepiduralfibrosisclassificationahistopathologicstudyintheratmodel AT kittijirarattanaphochai interraterreliabilityofthepostoperativeepiduralfibrosisclassificationahistopathologicstudyintheratmodel AT chatsumananont interraterreliabilityofthepostoperativeepiduralfibrosisclassificationahistopathologicstudyintheratmodel AT kriangkraiwittayapairoj interraterreliabilityofthepostoperativeepiduralfibrosisclassificationahistopathologicstudyintheratmodel AT kamolsaksukhonthamarn interraterreliabilityofthepostoperativeepiduralfibrosisclassificationahistopathologicstudyintheratmodel |