PURPOSE Patients with central lumbar spinal stenosis (LSS) have a longer symptom history, more severe stenosis, and worse postoperative outcomes, when redundant nerve roots (RNRs) are evident in the preoperative MRI. The objective was to test the inter- and intra-rater reliability of an MRI-based classification for RNR. METHODS This is a retrospective reliability study. A neuroradiologist, an orthopedic surgeon, a neurosurgeon, and three orthopedic surgeons in-training classified RNR on 126 preoperative MRIs of patients with LSS admitted for microsurgical decompression. On sagittal and axial T2-weighted images, the following four categories were classified: allocation (A) of the key stenotic level, shape (S), extension (E), and direction (D) of the RNR. A second read with cases ordered differently was performed 4 weeks later. Fleiss and Cohen's kappa procedures were used to determine reliability. RESULTS The allocation, shape, extension, and direction (ASED) classification showed moderate to almost perfect inter-rater reliability, with kappa values (95% CI) of 0.86 (0.83, 0.90), 0.62 (0.57, 0.66), 0.56 (0.51, 0.60), and 0.66 (0.63, 0.70) for allocation, shape, extension, and direction, respectively. Intra-rater reliability was almost perfect, with kappa values of 0.90 (0.88, 0.92), 0.86 (0.84, 0.88), and 0.84 (0.81, 0.87) for shape, extension, and direction, respectively. Intra-rater kappa values were similar for junior and senior raters. Kappa values for inter-rater reliability were similar between the first and second reads (p = 0.06) among junior raters and improved among senior raters (p = 0.008). CONCLUSIONS The MRI-based classification of RNR showed moderate-to-almost perfect inter-rater and almost perfect intra-rater reliability.

中文翻译：

---

腰椎管狭窄症中的冗余神经根：基于MRI的分类的评分间和评分间可靠性。

目的当术前MRI中明显有多余的神经根（RNR）时，患有中枢腰椎管狭窄（LSS）的患者病史更长，狭窄程度更重，术后预后更差。目的是测试基于MRI的RNR分类的评分者间和评分者内可靠性。方法这是一项回顾性可靠性研究。神经放射科医生，整形外科医生，神经外科医生和三名整形外科医生对接受显微外科减压的LSS患者的126例术前MRI进行分类RNR训练。在矢状和轴向T2加权图像上，分为以下四个类别：关键狭窄水平的分配（A），RNR的形状（S），延伸（E）和方向（D）。在4周后对病例进行了不同顺序的二读。弗莱斯和科恩 s的kappa程序用于确定可靠性。结果分配，形状，延伸和方向（ASED）分类显示出中等至几乎完美的评分者间可靠性，kappa值（95％CI）为0.86（0.83，0.90），0.62（0.57，0.66），0.56（0.51） ，0.60）和0.66（0.63，0.70）分别用于分配，形状，扩展和方向。评估者内部的可靠性几乎是完美的，形状，延伸和方向的kappa值分别为0.90（0.88，0.92），0.86（0.84，0.88）和0.84（0.81、0.87）。初级和高级评估者的评估者内部kappa值相似。在初次评估者中，第一次和第二次阅读之间的评估者间信度的Kapp值相似（p = 0.06），在高级评估者中，kappa值有所提高（p = 0.008）。