Correlation of Foraminal Parameters with Patient-Reported Outcomes in Patient with Degenerative Lumbar Foraminal Stenosis

Abstract

The relationship between quantitative anatomic parameters in MRI and patient-reported outcomes (PROs) before and after surgery in degenerative lumbar foraminal stenosis remains unknown. We included 58 patients who underwent transforaminal lumbar interbody fusion (TLIF) for single-level degenerative disc disease with foraminal stenosis between February 2013 and June 2020. PROs were evaluated using the visual analog scale (VAS) for back and leg pain, Oswestry Disability Index (ODI), and EuroQol-5D (EQ-5D). The foraminal parameters assessed using preoperative MRI included foraminal height, posterior intervertebral disc height, superior and inferior foraminal width, and foraminal area. The correlation between foraminal parameters and PROs before operation, at 1 year follow-up, and change from baseline were assessed. The associations between the aforementioned parameters were examined using linear regression analysis. The analysis revealed that among these parameters, superior foraminal width was found to be significantly correlated with ODI and EQ-5D at the 1 year follow-up and with change in ODI and EQ-5D from baseline. The associations remained significant after adjustment for confounding factors including age, sex, body mass index, and duration of hospital stay. The results indicated that in degenerative lumbar foraminal stenosis, decreased superior foraminal width was associated with better improvement in disability and quality of life after TLIF.

The Spatial Characteristics of Intervertebral Foramina within the L4/L5 and L5/S1 Motor Segments of the Spine

“…They tried to determine whether gender could be a factor differentiating these dimensions. The topic of intervertebral foramen was also reported by Giles [19], Fujiwara [20], and Lin [7]. The last of the studies cited showed that the anatomical parameters of the intervertebral foramen, assessed by preoperative MRI, were independently correlated with the results reported by patients with degenerative lumbar foramen stenosis.…”

“…Therefore, it is necessary to improve the diagnostic procedures related to the described disease entity [6]. It is estimated that stenosis of the intervertebral foramina is a problem for about 8-11% of the population [7]. Pathologies occurring within the intervertebral disc may lead to changes in the parameters of the intervertebral foramina.…”

“…Osteophytes of the facet joint and hypertrophic ligamentum flavum contribute to the reduction in the width and area of the foramen in the anterior-posterior dimension [8]. Changes occurring within the spinal canal may lead to compression of the lumbar nerve and dorsal root ganglion and result in the appearance of symptoms characteristic of spinal canal impingement [7].…”