• Pain Med · Jul 2021

    Simplified Universal Grading of Lumbar Spine MRI Degenerative Findings: Inter-reader agreement of non-radiologist spine experts.

    • Nityanand Miskin, Zacharia Isaac, Yi Lu, Melvin C Makhni, Danielle L Sarno, Timothy R Smith, Jay M Zampini, and Jacob C Mandell.
    • Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
    • Pain Med. 2021 Jul 25; 22 (7): 1485-1495.

    Objective1) To describe a simplified multidisciplinary grading system for the most clinically relevant lumbar spine degenerative changes. 2) To measure the inter-reader variability among non-radiologist spine experts in their use of the classification system for interpretation of a consecutive series of lumbar spine magnetic resonance imaging (MRI) examinations.MethodsATS multidisciplinary and collaborative standardized grading of spinal stenosis, foraminal stenosis, lateral recess stenosis, and facet arthropathy was developed. Our institution's picture archiving and communication system was searched for 50 consecutive patients who underwent non-contrast MRI of the lumbar spine for chronic back pain, radiculopathy, or symptoms of spinal stenosis. Three fellowship-trained spine subspecialists from neurosurgery, orthopedic surgery, and physiatry interpreted the 50 exams using the classification at the L4-L5 and L5-S1 levels. Inter-reader agreement was assessed with Cohen's kappa coefficient.ResultsFor spinal stenosis, the readers demonstrated substantial agreement (κ = 0.702). For foraminal stenosis and facet arthropathy, the three readers demonstrated moderate agreement (κ = 0.544, and 0.557, respectively). For lateral recess stenosis, there was fair agreement (κ = 0.323).ConclusionsA simplified universal grading system of lumbar spine MRI degenerative findings is newly described. Use of this multidisciplinary grading system in the assessment of clinically relevant degenerative changes revealed moderate to substantial agreement among non-radiologist spine physicians. This standardized grading system could serve as a foundation for interdisciplinary communication.© The Author(s) 2021. Published by Oxford University Press on behalf of the International Life Sciences Institute.All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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