The importance of morphological and clinical classifications of lumbar spine stenosis in the preoperative planning

Czech version

Authors: D. Bludovský; D. Štěpánek; M. Kulle; M. Choc; V. Přibáň
Authors‘ workplace: Neurochirurgická klinika LF UK a FN Plzeň
Published in: Cesk Slov Neurol N 2018; 81(1): 45-50
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn201845

Overview

Objective:
The aim of our study was to investigate the relations between subjective difficulties, clinical findings and the MRI in patients who have been operated for symptomatic lumbar spinal stenosis (LSS), and the possibility of using these relations for surgical treatment decision.

Methods:
Patients operated for LSS in 2009–2010 were included in the study. Subjective difficulties were assessed using the Oswestry Disability Index (ODI), the clinical symptoms with the modified Neurological Impairment Score for Lumbar Spinal Stenosis (mNIS-LSS). We measured the spinal canal area, dural sac area, and nerve root sedimentation classification on MRI. We tested the relations between these categories using the correlation analysis at significance level p < 0.05.

Results:
61 patients with a median age of 67 were included. Median ODI value was 48. Overall, we evaluated 162 spinal segments. Correlation coefficients for ODI, mNIS-LSS and graphical findings were less than 0.5. Correlation coefficients greater than 0.5 were between all the MRI measurement methods.

Conclusions:
In the group of patients indicated for surgery for symptomatic LSS, we did not found a statistically significant correlation between subjective patient difficulties, neurological findings and MRI. Statistically significant correlations are among the selected LSS measurement techniques for MRI. For common use, the easiest of them is nerve root sedimentation classification according to Schizas.

Key words:
lumbar spinal stenosis – lumbar spine – magnetic resonance imagining– surgical treatment

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Chinese summary - 摘要

腰椎管狭窄的形态学和临床分型在术前计划中的重要性

目的：

我们的研究目的是调查腰椎管狭窄症（LSS）手术患者的主观困难，临床表现和MRI之间的关系，以及使用这些关系进行手术治疗的可能性。

Methods:
方法：

研究包括2009-2010年为LSS手术的患者。使用Oswestry残疾指数（ODI）评估主观困难，使用修改的腰椎管狭窄症的神经学损伤评分（mNIS-LSS）评估临床症状。我们在MRI上测量的椎管面积，硬膜囊面积和神经根聚集程度。我们用显着性水平p <0.05的相关分析检验了这些类别之间的关系。

结果：

包括61名中位年龄为67岁的患者。中位ODI值为48.总的来说，我们评估了162个脊髓节段。 ODI，mNIS-LSS和图表发现的相关系数均小于0.5。所有MRI测量方法之间的相关系数大于0.5。

结论：

在有症状LSS手术指征的患者组中，我们没有发现患者主观困难，神经系统症状和MRI之间显著的统计学相关性。所选MRI的LSS测量技术在统计学上有着显著的相关性。根据Schizas，最常用的是神经根聚集程度。

关键词：

腰椎椎管狭窄 - 腰椎 - 磁共振成像 - 手术治疗

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