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Lumbar Canal Stenosis: A Prospective Clinicoradiologic Analysis
Nikhil Jain1, Shankar Acharya1, Nitin Maruti Adsul2
1Department of Orthospine, Sir Ganga Ram Hospital, New Delhi, India.
Journal of Neurological Surgery. Part A, Central European Neurosurgery
|February 29, 2020
Summary
Radiologic indicators like dural sac cross-sectional area and morphological grading effectively differentiate lumbar spinal stenosis from simple back pain. However, the Oswestry Disability Index, while indicating stenosis severity, shows no significant correlation with these radiologic findings.
Area of Science:
- Neurosurgery
- Radiology
- Orthopedics
Background:
- Lumbar spinal stenosis diagnosis relies on spinal canal narrowing, but the degree causing symptoms is unclear.
- Previous studies explored associations between spinal canal narrowing and clinical symptoms.
- This study prospectively compares radiologic and clinical criteria for lumbar spinal stenosis.
Purpose of the Study:
- To compare radiologic indicators of spinal canal stenosis with clinical assessments.
- To evaluate the correlation between magnetic resonance imaging (MRI) findings and patient-reported disability.
Main Methods:
- Utilized qualitative grading, dural sac cross-sectional area (DSCA), and sedimentation sign on MRI.
- Compared these with the Oswestry Disability Index (ODI) and Self-Paced Walking Test in 85 patients.
- Patients were grouped by neurogenic claudication severity and duration, or presence of simple back pain.
Main Results:
- Significant differences in ODI, DSCA, and sedimentation sign were found across patient groups.
- DSCA and sedimentation sign effectively distinguished simple back pain from lumbar spinal stenosis.
- While ODI indicated stenosis severity, it lacked significant statistical correlation with DSCA or morphological grading.
Conclusions:
- DSCA, morphological grading, and sedimentation sign are reliable radiologic indicators for differentiating lumbar spinal stenosis.
- The Oswestry Disability Index is a strong clinical indicator of stenosis severity.
- A significant correlation between clinical and radiologic parameters for lumbar spinal stenosis was not established in this study.
