To Assess Whether Lee’s Grading System for Central Lumbar Spinal Stenosis Can Be Used as a Decision-Making Tool for Surgical Treatment

Abstract

Purpose To evaluate the correlation between Lee’s grades and surgical intervention for central lumbar spinal stenosis (CLSS) and to assess whether this grading system can be used as a decision-making tool for the surgical treatment of this condition. Materials and Methods This retrospective study included 290 patients (M:F = 156:134; mean age, 46 ± 16 years). Radiologists assessed the presence and grade of CLSS at the stenosis point according to Lee’s grading system, in which CLSS is classified into four grades according to the shape of the cauda equina. Correlation coefficients ( r s ) between Lee’s grades and the operation were calculated with Spearman rank correlation. Results Among the operated patients, grade 2 was the most commonly assigned grade (50%–58%), grade 3 was less common (35%), and grade 0 was the least common (2%–3%). Among the non-operated patients, grade 1 was the most common (63%–65%), grade 0 was less common (15%–16%), and grade 3 was the least common (8%). The distribution of grades differed between the operated and non-operated groups ( p < 0.001). Less than 25% of patients who underwent surgery were assigned grades 0 and 1, and more than 88% were assigned grades 2 and 3. A moderate correlation was found between the grade and surgical intervention ( r s = 0.632 and r s = 0.583). Conclusion Lee’s grade was moderately correlated with surgical intervention. Lee’s grading system can be a decision-making tool for the surgical treatment of CLSS.

Role of Mri in the Diagnosis of Causes of Spinal Stenosis at Lumbosacral Region

“…Our study found the mean age of patients was 49.1±8.3, 55% of them belong group 40-60 year and 45% belong group 20-39 year. Ratio of Males to females was 1.3: 1 the male constituent 56.7% of sample in accordance with previous studies and in contrast to other studies recruited older age group [10][11][12].…”