Inter-examiner reliability in identifying lumbar paraspinal muscle atrophy by lumbar paraspinal muscle atrophy index, a novel parameter

[Purpose] To evaluate the inter-examiner reliability of our novel parameter, the lumbar paraspinal muscle atrophy index, in identifying the lumbar paravertebral muscle atrophy. [Participants and Methods] The study group consisted of 225 adults, with a mean age of 64.7 (range, 21–89) years, who underwent posterior lumbar spinal surgery for degenerative spinal disease at our hospital between July 2013 and June 2017. Preoperative axial T2-weighted magnetic resonance images were used to evaluate the lumbar paraspinal muscle atrophy index and observe the presence or absence of severe lumbar paraspinal muscle atrophy. The lumbar paraspinal muscle atrophy index was calculated at each intervertebral level, from L1-2 through L4-5, once by two examiners, and the Cohen’s kappa statistic was used to calculate the inter-examiner agreement of the classification of the presence or absence of atrophy at each level. [Results] The agreement was high (kappa, 0.79–0.88) for the lumbar paraspinal muscle atrophy index at all levels, except at the L3-4 level (kappa, 0.49). The lower kappa statistic at L3-4 likely reflects the unique morphological characteristics at this level. [Conclusion] The lumbar paraspinal muscle atrophy index is a new, simple, easy-to-use, and sufficiently reliable parameter to identify lumbar paraspinal atrophy.