Evaluation of the reliability of measuring lower back muscles cross-sectional area based on manual segmentation within multi-level MRI images

Manual segmentation of paraspinal muscle cross-sectional area (CSA) is widely used to assess related health disorders. This study aimed to evaluate the reliability of this segmentation process for each paraspinal region of interest across the three intervertebral levels commonly used for segmentation (L3/4, L4/5, and L5/S1).