Radiographic indices for lumbar developmental spinal stenosis

Cheung, Jason Pui Yin; Ng, Karen Ka Man; Samartzis, Dino

doi:10.1186/s13013-017-0113-3

Cited by 18 publications

(13 citation statements)

References 40 publications

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“…In the present study, 48 patients in the case group and 13 patients in the control group had anterior-posterior diameter at the intervertebral disc level less than 10mm, which was similar to that of Pawer et al and Cheung et al studies (18)(19). In the study by Cheung et al the mean interpanedular distance was 30 mm at T1 and was 29.8 at T2, which was slightly more than the current study`s result (19). Moreover, in the study by Pawer et al, this distance mean between the patient and healthy group was 30mm (18), which was higher than the mean of current study.…”

Section: Discussionsupporting

confidence: 91%

“…It has been suggested that the posterior-anterior diameter of the bony canal has little diagnostic importance and that what is important in this parameter, is the examination of the same area in the myelogram to examine the dural sac (7). In the present study, 48 patients in the case group and 13 patients in the control group had anterior-posterior diameter at the intervertebral disc level less than 10mm, which was similar to that of Pawer et al and Cheung et al studies (18)(19). In the study by Cheung et al the mean interpanedular distance was 30 mm at T1 and was 29.8 at T2, which was slightly more than the current study`s result (19).…”

Section: Discussionsupporting

confidence: 88%

“…In the study by Cheung et al mean posterior anterior diameter at L4-L5 level at T1 was 14.1 and at T2 level, it was 14.2, which was similar to the current study (19). In Pawer et al, mean posterior diameter of the canal at L4-L5 level in the symptomatic group was 9.05 mm and in the control group, it was11.13 mm, which had significant differences (18).…”

Section: Discussionsupporting

confidence: 86%

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Relationship Between Magnetic Resonance Imaging Findings and Clinical Symptoms in Patients with Suspected Lumbar Spinal Canal Stenosis: a Case-control Study

Majidi¹,

Shafizad²,

Niksolat³

et al. 2019

Acta Inform Med

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Introduction: Despite the availability of many imaging and clinical criteria for diagnosis of lumbar spinal stenosis (LSS), its correct diagnosis is a challenge for clinicians and radiologists. Aim: The aim of this study was to examine the relationship between magnetic resonance imaging (MRI) findings and clinical symptoms in symptomatic and asymptomatic patients with suspected LSS in MRI. Methods: This study is a case-control study. Two groups of 100 symptomatic and asymptomatic individuals (aged 20 to 84 years) with suspected lumbar spinal canal stenosis who referred to the imaging unit for lumbosacral MRI were included. The clinical symptoms and radiological parameters in MRI for all patients were recorded and relationship between them were evaluated. Results: Among the quantitative imaging findings, only the anterior-posterior diameter of the canal at the level of the intervertebral disc, the central spinal canal cross-section area and lateral recesses cross-sectional area were valuable. Coefficient of stenosis was calculated for the case and control groups which had statistically significant difference (p<0.001). The difference between qualitative findings such as disc protrusion, extrusion, sequestration and Cauda Equine serpain or redundant was significant between the two groups. Conclusion: According to the results, among the quantitative criteria of MRI imaging findings, central spinal canal cross-section (less than 77.5 mm2 for central stenosis) and lateral recesses cross-section (less than 22.5 mm2 for lateral stenosis) had the highest sensitivity and specificity for LSS diagnosis in symptomatic and asymptomatic patients with suspected LSS. Strongest observed correlation was between neurogenic claudication and LSS diagnostic radiological markers.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 86%

See 1 more Smart Citation

Relationship Between Magnetic Resonance Imaging Findings and Clinical Symptoms in Patients with Suspected Lumbar Spinal Canal Stenosis: a Case-control Study

Majidi¹,

Shafizad²,

Niksolat³

et al. 2019

Acta Inform Med

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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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“…One must appreciate the unique pathological characteristics of DSS that distinguish it from degenerative/acquired lumbar spinal stenosis. Previous studies have characterized DSS with both x‐ray and magnetic resonance imaging (MRI) phenotyping, having a paradoxical relationship with ligamentum flavum hypertrophy, and possible genetic origins . Yet, further understanding of its pathophysiology is necessary to determine the clinical significance of DSS.…”

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confidence: 99%

Novel compression rat model for developmental spinal stenosis

2019

Journal Orthopaedic Research

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Developmental spinal stenosis (DSS) is characterized by pre-existing circumferential narrowing of the bony spinal canal which predisposes neural tissue to compression. This study aims to create a reproducible animal model mimicking DSS for investigation of its pathoanatomy. Developmental spinal canal constriction was simulated using circumferential compression. Eighteen female Sprague-Dawley rats (13.0-14.5 weeks-old) underwent circumferential compression at L4-L5 using silicone sheets; or dorsal compression using overlapping silicone sheets; or as controls. A series of outcome scores were used for locomotor function assessment, together with electrophysiological and histological assessment. Assessment time-points were at preoperative, postoperative 1-week, 2weeks, 3-weeks, 1-month, and pre-sacrifice. Statistical analyses were performed. At all postoperative time-points, circumferential group had the worst mean Basso, Beattie and Bresnahan locomotor scores with significant difference from the control group (p < 0.05), as well as the lowest mean Louisville Swim Scale scores, as compared to the dorsal (p < 0.05) and to the control (p < 0.01) groups. Circumferential group had worse mean foot fault score for both hindlimbs (p < 0.01 to p < 0.05) and highest error rate in foot placement accuracy, especially higher than dorsal (p < 0.05) and control (p < 0.05) groups at pre-sacrifice. Electrophysiological assessment revealed postoperative increase in P1 latency was higher in circumferential than dorsal compression. Highest postoperative mean P1 latency was observed for both paws at all postoperative time-points for circumferential group (except at postoperative 1-week). Circumferential group had lower myelin-to-axonal area ratio and higher g-ratio than both the dorsal and control groups (p < 0.001). For each study group, hindlimb P1 latency and P1-N1 amplitude were each correlated with g-ratio (p < 0.05); and mean myelin-to-axonal area ratio correlated with P1 latency of both hindlimbs (p < 0.05). Based on these more severe axonal demyelination and neurological deficits, a valid DSS rat model is created with somatosensory evoked potential neuro-monitoring technique. ß 2019 Orthopaedic Research METHODS Model CreationA total of 18 female Sprague-Dawley (SD) rats of 13.0-14.5 week-old were utilized. All animal experiments involved in this study were approved by the Animal Ethics Committee. The rats were randomly allocated into 3 groups: Circumferential compression (n ¼ 6), dorsal compression (n ¼ 6), control (n ¼ 6). Circumferential compression was achieved using 0.51 mm thick silicone sheet. The silicone sheet was guided circumferentially to the dural sac from the operator side, and the ends of the silicone sheet were approximated and secured by a non-absorbable suture over the dorsal aspect (Fig. 1a). Dorsal compression was conducted by firstly removing the spinous process of L5, followed by insertion of silicone sheets dorsal to the dura, inducing compression at the region of L4-L5. Silicone sheets were doubled and ove...

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Radiographic indices for lumbar developmental spinal stenosis

Cited by 18 publications

References 40 publications

Relationship Between Magnetic Resonance Imaging Findings and Clinical Symptoms in Patients with Suspected Lumbar Spinal Canal Stenosis: a Case-control Study

Relationship Between Magnetic Resonance Imaging Findings and Clinical Symptoms in Patients with Suspected Lumbar Spinal Canal Stenosis: a Case-control Study

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

Novel compression rat model for developmental spinal stenosis

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