Association Between Radiological Stenosis Level and Patient-Reported Outcomes in Patients with Lumbar Spinal...

Background and Objectives: The aim of this study was to evaluate the relationship between low back pain questionnaires and radiological stenosis severity in patients with lumbar spinal stenosis (LSS). Materials and Methods: Patients aged 50 years and over who presented with complaints of low back pain and were diagnosed or not diagnosed with LSS by magnetic resonance imaging (MRI) were included in the study. Demographic data, physical examination findings, and walking distance were recorded. Pain severity was assessed using the Visual Analog Scale (VAS), and patients completed the Oswestry Disability Index (ODI), the Istanbul Low Back Pain Disability Index (ILBPDI), and the Swiss Spinal Stenosis Questionnaire (SSS-Q). Results: A total of 120 patients with LSS (n = 56) and without LSS (n = 64) were included in the study. No significant differences were found between the groups in terms of demographic variables (p > 0.05). Neurogenic claudication and lumbar extension limitation were higher in the LSS group (p = 0.033 and p = 0.008, respectively), and walking distance was significantly shorter compared to the group without LSS (p = 0.024). There were significant differences between the VAS, ODI, ILBPDI, and SSS-Q scores between the two groups (p < 0.05). A strong positive correlation exists between the radiological severity of LSS and SSS-Q (p < 0.001, r = 0.707). Additionally, ROC analysis revealed that the SSS-Q had a significantly higher diagnostic value for LSS compared to the ODI and ILBPDI (p < 0.001). For the SSS-Q, likelihood ratios indicated limited diagnostic relevance (PLR 4.04 [95% CI: 2.45-6.67]; NLR 0.22 [95% CI: 0.13-0.44]). Conclusions: SSS-Q, ODI, and ILBPDI scores vary significantly between patients with and without LSS. Although the SSS-Q correlates most strongly with radiological LSS severity, its diagnostic utility appeared of minor importance, as likelihood ratios indicated limited discriminative ability.