A new comprehensive MRI classification and grading system for lumbosacral central and lateral stenosis: clinical application and comparison with previous systems

Spinnato, Paolo; Petrera, Miriana Rosaria; Parmeggiani, Anna; Manzetti, Marco; Ruffilli, Alberto; Faldini, Cesare; D’Agostino, Valerio; Di Carlo, Maddalena; Cumani, Maria Pia; Crombé, Amandine; Matcuk, George R.; Miceli, Marco

doi:10.1007/s11547-023-01741-3

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…Importantly a recent update of the MRI grading for spinal stenosis included SEL as one of the three main causes of lumbosacral spinal stenosis (along with disc pathology, ligamentous thickening/hypertrophy, and facet joint arthritis with or without synovial cysts) indicated as a subcategory Alpha in Manjila grading of SEL. This gives a complete radiological picture of coexisting degenerative spine disease in conjunction with SEL ( 16 ). This suggests that SEL is gaining prominence in the awareness of clinicians and radiologists.…”

Section: Discussionmentioning

confidence: 99%

Case Report: Technical description and clinical evaluation of three cases of unilateral biportal endoscopic decompression for symptomatic spinal epidural lipomatosis

Liu,

Cai,

Zhao

et al. 2024

Front. Surg.

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ObjectiveTo investigate the clinical characteristics and outcomes of three patients with symptomatic Spinal epidural lipomatosis (SEL) treated using Unilateral Biportal Endoscopic (UBE) surgery.MethodsThis report retrospectively analyzed the clinical data of three patients with SEL admitted to our hospital. The analysis covers onset characteristics, clinical manifestations, and the most recent radiologic grading system of neural compression (Manjila classification). Furthermore, it details the decompression accomplished through the application of a minimally invasive UBE surgical technique, specifically targeting the removal of proliferated fat responsible for nerve and spinal cord compression.ResultsThis technique was performed successfully in 3 patients with SEL. Radiating pain was reduced, and the functional disability and radiologic compression were improved in all three patients. Postoperative spinal instability and surgical complications related to the procedure were not observed.ConclusionsFor SEL, timely diagnosis and appropriate intervention can prevent the progression of neurological disability. UBE is a minimally invasive muscle-preserving technique that achieves neural decompression directly by the removal of excessive intraspinal adipose tissue buildup.

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Section: Discussionmentioning

confidence: 99%

Case Report: Technical description and clinical evaluation of three cases of unilateral biportal endoscopic decompression for symptomatic spinal epidural lipomatosis

Liu,

Cai,

Zhao

et al. 2024

Front. Surg.

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“…Most of them are focused on spinal canal narrowing, with a few others also including grading of the lateral foramen. Recently, Spinnato et al provided a comprehensive MRI severity-grading system for central and lateral lumbar spine stenosis, with inclusion of the main causes of disease schematized into four categories: (i) disc, (ii) arthritis, (iii) epidural lipomatosis, and (iv) mixed causes [ 49 ]. This is currently the most comprehensive and the only system to include all causes of stenosis, and can rapidly help clinicians to choose the appropriate treatment strategies, including surgery, image-guided minimally invasive treatments, and conservative treatments (e.g., oral drugs and weight loss).…”

Section: Image-guided Minimally Invasive Treatmentsmentioning

confidence: 99%

Image-Guided Minimally Invasive Treatment Options for Degenerative Lumbar Spine Disease: A Practical Overview of Current Possibilities

Taninokuchi Tomassoni,

Braccischi,

Russo

et al. 2024

Diagnostics

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Lumbar back pain is one of the main causes of disability around the world. Most patients will complain of back pain at least once in their lifetime. The degenerative spine is considered the main cause and is extremely common in the elderly population. Consequently, treatment-related costs are a major burden to the healthcare system in developed and undeveloped countries. After the failure of conservative treatments or to avoid daily chronic drug intake, invasive treatments should be suggested. In a world where many patients reject surgery and prefer minimally invasive procedures, interventional radiology is pivotal in pain management and could represent a bridge between medical therapy and surgical treatment. We herein report the different image-guided procedures that can be used to manage degenerative spine-related low back pain. Particularly, we will focus on indications, different techniques, and treatment outcomes reported in the literature. This literature review focuses on the different minimally invasive percutaneous treatments currently available, underlining the central role of radiologists having the capability to use high-end imaging technology for diagnosis and subsequent treatment, allowing a global approach, reducing unnecessary surgeries and prolonged pain-reliever drug intake with their consequent related complications, improving patients’ quality of life, and reducing the economic burden.

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“…Due to the similarity of surgical approaches between PEID and UBE, they have been widely compared by global scholars [18][19] , but few have further classi ed LDD 20 , so as to compare the in uence of the two approaches on perioperative period and prognosis. According to research reports, indications for lumbar total endoscopic surgery include lumbar disc herniation ( central paramedian foraminal extraforaminal Migrated disc) and lumbar spinal stenosis ( lateral recess stenosis central canal stenosis ossi cation of ligamentum luteum foraminal stenosis) 10 .Based on the classi cation of LDD, the purpose of this paper is to compare the perioperative conditions, long-term and short-term effects and complications of the treatment of LDD by PEID technology and UBE technology, as well as the differences in the relief degree of LDD related symptoms between the two endoscopic surgery methods, so as to select the appropriate endoscopic surgery methods for different patients.…”

Section: Introductionmentioning

confidence: 99%

Title：Percutaneous endoscopic interlaminar discectomy versus unilateral biportal endoscopy in the treatment of L5/S1 degeneration disease: a randomized controlled trial

Wu,

Tao,

et al. 2024

Preprint

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Background: Lumbar degenerative disease(LDD)is a prevalent condition that significantly impairs individuals'quality of life due to the presence of lower back and leg pain symptoms. This retrospective study was designed to compare and analyze the clinical outcomes of percutaneous endoscopic interlaminar discectomy(PEID)and unilateral biportal endoscopy(UBE) in the treatment of LDD. Methods: A total of 79 L5/S1 LDD patients admitted to the Spinal Surgery Department of the First Affiliated Hospital of Chongqing Medical University from September 2020 to May 2023 were selected and divided into Group A(PEID) and Group B(UBE) according to different surgical methods.Basic data, preoperative and postoperative lumbar and leg pain scores (as measured by the visual analogue Scale [VAS]), and functional recovery (as measured by the Dysfunction Index [ODI] score) were assessed for each group.The statistical analysis of the results from both groups was conducted using SPSS 25.0 software. Results: There were significant differences in postoperative lumbar and leg pain scores and functional impairment indexes between the two groups. Lower back pain score 1 day and 1 month after surgery in PEID group was lower than that in UBE group, and leg pain score 1 day, 1 month and 3 months after surgery in PEID group was lower than that in UBE group. The functional impairment index at 1 day, 1 month, 3 months and 6 months after operation in UBE group was lower than that in PEID group, and the difference was statistically significant (P < 0.05). Conclusion: This study suggests that although both approaches are effective in the treatment of L5/S1 degenerative diseases and can relieve back and leg pain and dysfunction, UBE is more advantageous in the treatment of central canal stenosis, and PEID is more effective in the short-term relief of back and leg pain caused by central protrusion. This may provide a basis for patients to make personalized surgical plans.

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A new comprehensive MRI classification and grading system for lumbosacral central and lateral stenosis: clinical application and comparison with previous systems

Cited by 6 publications

References 24 publications

Case Report: Technical description and clinical evaluation of three cases of unilateral biportal endoscopic decompression for symptomatic spinal epidural lipomatosis

Case Report: Technical description and clinical evaluation of three cases of unilateral biportal endoscopic decompression for symptomatic spinal epidural lipomatosis

Image-Guided Minimally Invasive Treatment Options for Degenerative Lumbar Spine Disease: A Practical Overview of Current Possibilities

Title：Percutaneous endoscopic interlaminar discectomy versus unilateral biportal endoscopy in the treatment of L5/S1 degeneration disease: a randomized controlled trial

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