Inter-examiner reliability in identifying lumbar paraspinal muscle atrophy by lumbar paraspinal muscle atrophy index, a novel parameter.
Yuki Hasebe, Kenta Suzuki, Kiyokazu Akasaka and 2 others
PMID 36337221WHAT IT FOUND
Two examiners using a new MRI index agreed well on severe lumbar paraspinal muscle atrophy at L1-2, L2-3 and L4-5, but less consistently at L3-4.
It is a visual MRI classification, but no patient outcomes were tested.
Key findings
01LPMAI was measured by two examiners on preoperative T2-weighted axial MR images at L1-2 through L4-5.
02Inter-examiner agreement using LPMAI was significant at all levels, with k=0.88 at L1-2, k=0.86 at L2-3, k=0.69 at L3-4, and k=0.79 at L4-5 in the results text.
03Table 1 reports k=0.49 at L3/4, while the results text reports k=0.69.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
All participants had posterior lumbar surgery for degenerative disease, so the images may not represent people without lumbar surgery. The mean age was 64.7 years, and the authors note the group may not represent a healthy population. The paper reports reliability only; it does not report patient outcomes or treatment response. Reliability at L3-4 is uncertain because the results text reports k=0.69 while Table 1 reports k=0.49. The work was single-center and used only two examiners, so it does not show how widely the method can be applied.
Declared interests
The authors declared no conflict of interest, and the study was not funded.
The easy way to misread this
Do not conclude that LPMAI improves patient care or identifies clinically meaningful atrophy. The study only tested whether two examiners agreed on an MRI classification, and it did not measure patient outcomes.