Structured Education Improves MRI Lumbar Stenosis Grading Concordance

A structured educational intervention on a lumbar spinal stenosis classification system improved overall MRI grading correctness from 54.5% to 61.2% (p=0.006) and raised interobserver reliability (ICC from 0.71 to 0.75; p=0.030) among 37 multi-specialty physicians.

• Cases with clinically discrepant grades (>1 grade difference, e.g., mild vs. severe) fell from 3.7% to 2.0% post-intervention (p=0.002).
• Study included 114 lumbar disc levels graded by musculoskeletal radiologists, neuroradiologists, radiology residents, orthopedic surgeons, neurosurgeons, and physiatrists.
• Musculoskeletal radiology had the highest pre-intervention accuracy (67.7% correct); neuroradiology achieved the lowest discrepant rate post-intervention (0.7%).

Retrospective single-reader study without an established RADS system; the classification system used was study-specific rather than a validated clinical reporting standard.

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