Magnetic resonance imaging predictors of surgical outcome in degenerative lumbar spinal stenosis

Alıcıoğlu, Banu; Yılmaz, Barış; Bulakbaşı, Nail; Çopuroğlu, Cem; Yalnız, Erol; Aykac, Bilal; Urut, Devrim Ulaş

doi:10.1007/s11604-012-0125-0

Cited by 7 publications

(6 citation statements)

References 32 publications

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“…Thus, this region came to be known as the hidden zone. The development of new diagnostic modalities, especially MRI, may aid in hidden zone detection [131415]. However, difficulty detecting mid-zone lesion with conventional radiologic examinations even with CT and MRI was also stressed in that study.…”

Section: Discussionmentioning

confidence: 95%

Significance of Coronal Proset Magnetic Resonance Imaging to Detect Hidden Zone of the Mid-Zone Stenosis in the Lumbar Spine and Morphometric Analysis of the Mid-Zone Stenosis

et al. 2016

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Study DesignRetrospective exploratory imaging study.PurposeTo investigate the significance of the coronal magnetic resonance imaging (MRI) using Proset technique to detect the hidden zone in patients with mid-zone stenosis by comparing with conventional axial and sagittal MRI and to explore the morphologic characteristic patterns of the mid-zone stenosis.Overview of LiteratureDespite advancements in diagnostic modalities such as computed tomography and MRI, stenotic lesions under the pedicle and pars interarticularis, also called the mid-zone, are still difficult to definitely detect with the conventional axial and sagittal MRI due to its inherited anatomical peculiarity.MethodsOf 180 patients scheduled to undergo selective nerve root block, 20 patients with mid-zone stenosis were analyzed using MRI. Characteristic group patterns were also explored morphologically by comparing MRI views of each group after verifying statistical differences between them. Hierarchical cluster analysis was performed to classify morphological characteristic groups based on three-dimensional radiologic grade for stenosis at all three zones.ResultsAt the mid-zone, the stenosis of grade 2 or more was found in 14 cases in the coronal image,13 cases in the sagittal image, and 9 cases in the axial image (p<0.05). Especially, mid-zone stenosis was not detected in six of 20 cases at the axial images. At the entrance and exit-zone, coronal image was also associated with more accurate detection of hidden zone compared to other views such as axial and sagittal images. After repeated statistical verification, the morphological patterns of hidden zone were classified into 5 groups: 6 cases in group I; 1 case in group II; 4 cases in group III; 7 cases in group IV; and 2 cases in group V.ConclusionsCoronal MRI using the Proset technique more accurately detected hidden zone of the mid-zone stenosis compared to conventional axial and sagittal images.

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Section: Discussionmentioning

confidence: 95%

Significance of Coronal Proset Magnetic Resonance Imaging to Detect Hidden Zone of the Mid-Zone Stenosis in the Lumbar Spine and Morphometric Analysis of the Mid-Zone Stenosis

et al. 2016

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“…Stenosis develops due to disc degeneration in intervertebral connection points, facet artropathy, ligamentum flavum hypertrophy, spondylosis and sometimes due to the complex process of spondylolisthesis (9,11). Neurological claudication is the most frequent indication for spinal surgery in individuals diagnosed with lumbar spinal stenosis over 60 years (2,6,13).…”

Section: Discussionmentioning

confidence: 99%

“…Currently MRI has a better spatial resolution and capacity to show soft tissue changes such as ligamentum flavum, disc herniation etc. Preoperative MRI variables and surgical outcomes of patients were compared in a study which two groups had no difference, according to the degree of disc degeneration, foraminal stenosis, facet arthrosis and presence of listhesis p<0.05(2). We also considered the proposal regarding correlation between surgical outcome and postoperative imaging (MRI or CT scans) of surgically treated LSS patients, but in our study, postoperative imaging was based on radiography.…”

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confidence: 99%

Investigation of Postoperative Recovery State of Lumbar Spinal Stenosis Patients: A Single Center Experience

Altunel¹,

Ozturkeri²,

Söylev³

et al. 2016

West Indian Med J

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“…It is an important factor to consider in spinal stenosis surgery as patients with DSS have a high reoperation rate of up to 22% [23][24][25] . A large amount of studies focused on defining DSS radiologically 22,[26][27][28][29][30][31] , but only a few investigated its clinical course and clinical presentation 9,32 . Subjects with DSS are found to have earlier onset of symptoms during their fourth or fifth decades 33 as mild degenerative changes of the lumbar spine are already sufficient to compress the neural elements.…”

Section: Introductionmentioning

confidence: 99%

Clinical implications of lumbar developmental spinal stenosis on back pain, radicular leg pain, and disability

Lai

Cheung

Samartzis

et al. 2021

The Bone & Joint Journal

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Aims To study the associations of lumbar developmental spinal stenosis (DSS) with low back pain (LBP), radicular leg pain, and disability. Methods This was a cross-sectional study of 2,206 subjects along with L1-S1 axial and sagittal MRI. Clinical and radiological information regarding their demographics, workload, smoking habits, anteroposterior (AP) vertebral canal diameter, spondylolisthesis, and MRI changes were evaluated. Mann-Whitney U tests and chi-squared tests were conducted to search for differences between subjects with and without DSS. Associations of LBP and radicular pain reported within one month (30 days) and one year (365 days) of the MRI, with clinical and radiological information, were also investigated by utilizing univariate and multivariate logistic regressions. Results Subjects with DSS had higher prevalence of radicular leg pain, more pain-related disability, and lower quality of life (all p < 0.05). Subjects with DSS had 1.5 (95% confidence interval (CI) 1.0 to 2.1; p = 0.027) and 1.8 (95% CI 1.3 to 2.6; p = 0.001) times higher odds of having radicular leg pain in the past month and the past year, respectively. However, DSS was not associated with LBP. Although, subjects with a spondylolisthesis had 1.7 (95% CI 1.1 to 2.5; p = 0.011) and 2.0 (95% CI 1.2 to 3.2; p = 0.008) times greater odds to experience LBP in the past month and the past year, respectively. Conclusion This large-scale study identified DSS as a risk factor of acute and chronic radicular leg pain. DSS was seen in 6.9% of the study cohort and these patients had narrower spinal canals. Subjects with DSS had earlier onset of symptoms, more severe radicular leg pain, which lasted for longer and were more likely to have worse disability and poorer quality of life. In these patients there is an increased likelihood of nerve root compression due to a pre-existing narrowed canal, which is important when planning surgery as patients are likely to require multi-level decompression surgery. Cite this article: Bone Joint J 2021;103-B(1):131–140.

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Magnetic resonance imaging predictors of surgical outcome in degenerative lumbar spinal stenosis

Abstract: Surgical outcomes of DLSS depend on multiple variables. It is not possible to predict the outcomes by assessing only one parameter. The possible outcomes should be analyzed by considering all the factors individually.

Cited by 7 publications

References 32 publications

Significance of Coronal Proset Magnetic Resonance Imaging to Detect Hidden Zone of the Mid-Zone Stenosis in the Lumbar Spine and Morphometric Analysis of the Mid-Zone Stenosis

Significance of Coronal Proset Magnetic Resonance Imaging to Detect Hidden Zone of the Mid-Zone Stenosis in the Lumbar Spine and Morphometric Analysis of the Mid-Zone Stenosis

Investigation of Postoperative Recovery State of Lumbar Spinal Stenosis Patients: A Single Center Experience

Clinical implications of lumbar developmental spinal stenosis on back pain, radicular leg pain, and disability

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