Adult spinal process impingement syndrome: progression and staging

Area of Science:

• Orthopedics
• Radiology
• Spine Surgery

Background:

• Adult spinal process impingement (SPI) is a condition affecting the spine.
• Understanding its progression is crucial for effective treatment.
• Previous studies have lacked long-term, MRI-based longitudinal data.

Purpose of the Study:

• To investigate the natural progression of adult spinal process impingement (SPI).
• To develop a novel staging system for SPI.
• To establish a grading system for herniation of the interspinal ligament (HISL).

Main Methods:

• Retrospective, long-term MRI-based longitudinal study of 132 patients (mean follow-up 11.7 years).
• Patients divided into groups with and without SPI.
• Radiographic assessment, DEXA scans for osteoporosis, and analysis of L3/S1 levels.

Main Results:

• A four-stage SPI progression system was established: early, soft tissue, bone, and spinal stenosis.
• Osteoporosis identified as a key factor in SPI development.
• Herniation of the interspinal ligament (HISL) was present in 28 segments of the SPI group and associated with spinal stenosis.

Conclusions:

• The study delineated the stages and natural progression of SPI using long-term MRI.
• HISL is strongly associated with SPI, and its size is a principal factor in spinal stenosis.
• The developed staging and grading systems provide a framework for understanding and managing SPI.