Spine
Spine
5 years ago

Preoperative MRI in Patients With Intermittent Neurogenic Claudication: Relevance for Diagnosis and Prognosis

Schenck, Catharina D., Peul, Wilco C., Vleggeert-Lankamp, Carmen L.A.M., Lycklama à Nijeholt, Geert J., Van der Kallen, Bas F., for the Leiden-The Hague Spine Intervention Prognostic Study Group (SIPS), Moojen, Wouter A., Arts, Mark P., Jacobs, Wilco C.H.
Study Design. We studied baseline magnetic resonance images of 155 patients with intermittent neurogenic claudication and lumbar spinal stenosis (LSS). Magnetic resonance imaging (MRI) and patient data were gathered from participants of a randomized trial. Objective. It is believed that the narrowness of the lumbar spinal canal correlates to the severity of complaints and that it may be a good predictor of clinical outcome if treated. However, this hypothesis has never been (prospectively) tested. Summary of Background Data. MRI is an important tool to confirm the diagnosis of LSS as a cause for intermittent neurogenic claudication. Methods. Three raters were asked to evaluate the magnetic resonance images (Schizas scale). Symptom severities at baseline and 1-year follow-up were quantified. The radiological scores were correlated with clinical baseline and outcome scores to assess diagnostic and prognostic value of MRI findings at baseline. Results. There was good agreement on the clinically relevant level of LSS (kappa range 0.57–0.64). MRI assessment of grading of compression (kappa 0.33–0.46) did not correlate with baseline MRDQ nor with outcome based on postoperative change in MRDQ (P = 0.61). However, both absence of epidural fat and presence of tortuous caudal nerves on magnetic resonance images (kappa 0.53–0.72 and 0.67–0.70) in patients with LSS were relatively good predictors for satisfactory recovery after surgery (P = 0.03 and P < 0.01). Conclusion. The grading of compression on the preoperative MRI is neither ambiguous nor correlating to severity of clinical condition. It does, furthermore, not have the ability to predict the outcome after 1 year if surgically treated. Level of Evidence: 2

Publisher URL: https://journals.lww.com/spinejournal/Fulltext/2018/03010/Preoperative_MRI_in_Patients_With_Intermittent.11.aspx

DOI: 10.1097/BRS.0000000000001301

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.