Is There an Association Between Radiological Severity of Lumbar Spinal Stenosis and Disability, Pain, or Surgical Outcome?

Weber, Clemens; Giannadakis, Charalampis; Rao, Vidar; Jakola, Asgeir Store; Nerland, Ulf S.; Nygaard, Øystein P.; Solberg, Tore; Gulati, Sasha; Solheim, Ole

doi:10.1097/brs.0000000000001166

Cited by 65 publications

(49 citation statements)

References 33 publications

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“…Management of spinal stenosis can be challenging and requires the integration of individual symptoms, clinical findings, and diagnostic imaging. A recent study showed that, in individuals undergoing decompressive surgery for LSS, there was no association between severity of stenosis on preoperative magnetic resonance imaging and preoperative disability or clinical outcomes . This puts further emphasis on medical history taking and clinical investigation.…”

Section: Discussionmentioning

confidence: 99%

“…A recent study showed that, in individuals undergoing decompressive surgery for LSS, there was no association between severity of stenosis on preoperative magnetic resonance imaging and preoperative disability or clinical outcomes. 32 This puts further emphasis on medical history taking and clinical investigation. Several clinical signs and symptoms may be present in individuals with symptomatic LSS, including radiating leg pain that is exacerbated by standing or walking and pain relief when seated or bending forward, and many individuals present with gait disturbances.…”

Section: Discussionmentioning

confidence: 99%

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Surgery for Lumbar Spinal Stenosis in Individuals Aged 80 and Older: A Multicenter Observational Study

Giannadakis

Solheim

Jakola

et al. 2016

J American Geriatrics Society

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surgery for Lumbar Spinal Stenosis in Individuals Aged 80 and Older: A Multicenter Observational Study

Giannadakis

Solheim

Jakola

et al. 2016

J American Geriatrics Society

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“…There are conflicting results about the association between radiological and clinical findings. In a multicenter study, no relationship was shown between the radiological severity and the presence of back or leg pain in patients with LSS (23). In another research, the opposite was shown to some extent (24).…”

Section: Resultsmentioning

confidence: 94%

Neuropathic Pain and Disability in Patients with Lumbar Spinal Stenosis

Ağırman¹,

Akgün²

2018

tjgeri

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In this study, we aimed to determine the characteristics of neuropathic pain and clarify the relationships between the clinical signs, symptom characteristics and disability in patients with lumbar spinal stenosis. Materials and Method: Seventy-nine patients diagnosed with clinical and radiological lumbar spinal stenosis were included in the study. Pain severity was assessed using a selfadministered visual analog scale (0-10 cm). Subjective disability was measured using the Oswestry Disability Index and Istanbul Low Back Pain Disability Index. To identify neuropathic pain, the physician-administered Douleur Neuropathique 4 questionnaire was utilized. Results: A total of 79 patients (35 males, 44 females) with a mean age of 56.88±12.13 (range, 35-89) years were included in the study. The average symptom duration was 24.5 months. The Douleur Neuropathique 4 score was ≥4 in 41 patients (51.8%), indicating that they had neuropathic pain. A significant correlation was observed between the Douleur Neuropathique 4 score and age (R=0.350, p=0.002), body mass index (R=0.239, p=0.034), and visual analog scale (R=0.453, p< 0.001). Conclusion: Approximately half of all patients with lumbar spinal stenosis in our cohort had neuropathic pain. Higher age, body mass index and increased pain scores demonstrate important relationships with neuropathic pain.

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“…Weber et al evaluated the correlation between the severity of stenosis and clinical presentation [21]. They found no clinical correlation between the radiological severity of lumbar spinal stenosis and the nature of the clinical findings, including disability, pain, and surgical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Nerve Root Sedimentation Sign: Can It Predict the Success for Surgical Intervention in Patients With Symptomatic Lumbar Spinal Stenosis?

Badve

Kurra

Geisler

et al. 2020

Cureus

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Introduction: The use of interspinous process devices are less invasive surgical methods designed to manage mild to moderate lumbar spinal stenosis symptoms. Symptomatic relief may not be seen in all patients undergoing this procedure. Magnetic resonance imaging (MRI) parameters have been used to predict the success of clinical outcomes in patients with symptomatic lumbar spinal stenosis for decompressive surgeries. The purpose of this study was to determine the feasibility of using nerve root sedimentation sign to predict mid-to long-term clinical outcomes of patients treated with interspinous spacers for lumbar spinal stenosis. Methods: This was a retrospective study using prospective multicenter Food and Drug Administration Investigational Device Exemption (FDA IDE) trial (Superion™ and X-STOP®) data. Inclusion criteria were patients treated with interspinous spacers, aged 45 or older with lumbar spinal stenosis at one or more contiguous levels from L1 to L5 and symptoms of neurogenic claudication. Preoperative axial T2 weighted MRI images were used to determine nerve root sedimentation sign. Preoperative, six-week, one-and two-year postoperative clinical outcomes were measured using Oswestry Disability Index (ODI) scores. Clinical outcomes were compared between positive and negative nerve root sedimentation sign groups; p ≤0.05 was considered significant. Results: This study included n=374 patients; 40 excluded; 334 included (113=positive nerve root sedimentation sign (NRSS) (34%) and 221=negative NRSS (66%)). At six weeks, significant postoperative ODI correction was noted in both groups (p<0.001). No significant differences in ODI scores were identified between groups. A subgroup analysis with MRI image quality grade 3 and certainty determination grade 5, six-week postoperative ODI correction was significant in both groups. Six-week, one-and two-year postoperative ODI scores were greater by 6 points in the positive nerve root sedimentation sign group compared to the negative nerve root sedimentation sign group. Conclusions: Although satisfactory postoperative improvement occurred in both groups, there were statistically significant differences noted in certain sub-categories. The subgroup analysis indicated MRI image quality and nerve root sedimentation sign certainty of determination may be factors that may aid with planning the surgical management of lumbar spinal stenosis.

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Is There an Association Between Radiological Severity of Lumbar Spinal Stenosis and Disability, Pain, or Surgical Outcome?

Abstract: 2.

Cited by 65 publications

References 33 publications

Surgery for Lumbar Spinal Stenosis in Individuals Aged 80 and Older: A Multicenter Observational Study

Surgery for Lumbar Spinal Stenosis in Individuals Aged 80 and Older: A Multicenter Observational Study

Neuropathic Pain and Disability in Patients with Lumbar Spinal Stenosis

Nerve Root Sedimentation Sign: Can It Predict the Success for Surgical Intervention in Patients With Symptomatic Lumbar Spinal Stenosis?

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