Preoperative MRI Findings Predict Two-Year Postoperative Clinical Outcome in Lumbar Spinal Stenosis

Abstract

PurposeTo study the predictive value of preoperative magnetic resonance imaging (MRI) findings for the two-year postoperative clinical outcome in lumbar spinal stenosis (LSS).Methods84 patients (mean age 63±11 years, male 43%) with symptoms severe enough to indicate LSS surgery were included in this prospective observational single-center study. Preoperative MRI of the lumbar spine was performed with a 1.5-T unit. The imaging protocol conformed to the requirements of the American College of Radiology for the performance of MRI of the adult spine. Visual and quantitative assessment of MRI was performed by one experienced neuroradiologist. At the two-year postoperative follow-up, functional ability was assessed with the Oswestry Disability Index (ODI 0–100%) and treadmill test (0–1000 m), pain symptoms with the overall Visual Analogue Scale (VAS 0–100 mm), and specific low back pain (LBP) and specific leg pain (LP) separately with a numeric rating scale from 0–10 (NRS-11). Satisfaction with the surgical outcome was also assessed.ResultsPreoperative severe central stenosis predicted postoperatively lower LP, LBP, and VAS when compared in patients with moderate central stenosis (p<0.05). Moreover, severe stenosis predicted higher postoperative satisfaction (p = 0.029). Preoperative scoliosis predicted an impaired outcome in the ODI (p = 0.031) and lowered the walking distance in the treadmill test (p = 0.001). The preoperative finding of only one stenotic level in visual assessment predicted less postoperative LBP when compared with patients having 2 or more stenotic levels (p = 0.026). No significant differences were detected between quantitative measurements and the patient outcome.ConclusionsRoutine preoperative lumbar spine MRI can predict the patient outcome in a two-year follow up in patients with LSS surgery. Severe central stenosis and one-level central stenosis are predictors of good outcome. Preoperative finding of scoliosis may indicate worse functional ability.

Real-world study for identifying the predictive factors of surgical intervention and the value of magnetic resonance imaging in patients with low back pain

“…Preoperative MRI may be helpful for selecting the optimal operation methods and predict the prognosis of LBP patients after surgical treatment. Kuittinen et al reported that preoperative MRI of the lumbar spine could predict the outcome of LBP patients after surgical treatment in a 2-year follow up period (27). In their study, the additional MRI indicated that the severe lumbar spinal central stenosis could predict lower LBP and leg pain when compared to that in patients with moderate central stenosis after surgical treatment.…”

Obese people benefit from lumbar spinal stenosis surgery as much as people of normal weight

“…Moreover, the addition of arthrodesis to decompression was not separately evaluated. Kuittinen et al [ 13 ] found that severe central stenosis and one-level central stenosis predict a positive outcome of LSS surgery, while multilevel stenosis is associated with a negative outcome. Herno et al [ 14 ] found that patients with previous back surgery had a significant negative impact on the outcome of reoperation for LSS.…”

Determination of Work Relative Value Units for Management of Lumbar Spinal Stenosis by Open Decompression and Interlaminar Stabilization

“…Lumbar spinal stenosis (LSS) has grown in importance over the past decade in response to the rising older population [1][2][3] and has become the most common surgical indication for people over 65 years of age. 1,4 In the United States, Deyo et al 5 found that from 2002-2007, there were 135.5-137.5 persons 100 000 Medicare beneficiaries aged 65 and older who underwent lumbar stenosis surgery. In 2007 alone, hospital costs for LSS operations accounted for almost $1.65 billion (2009 dollars).…”