Relationship between sedimentation sign and morphological grade in symptomatic lumbar spinal stenosis

被引:26
作者
Laudato, P. A. [1 ]
Kulik, G. [1 ]
Schizas, C. [2 ]
机构
[1] Univ Lausanne, CHU Vaudois, Dept Orthoped, Lausanne, Switzerland
[2] Clin Cecil, Hirslanden Grp Private Hosp, Neuroorthopaed Spine Unit, Lausanne, Switzerland
关键词
Lumbar spinal stenosis; Morphological stenosis grade; Sedimentation sign; Imaging studies; Classification; MAGNETIC-RESONANCE; DECISION-MAKING; DURAL SAC; ARACHNOIDITIS; CT;
D O I
10.1007/s00586-015-4021-z
中图分类号
R74 [神经病学与精神病学];
学科分类号
100204 [神经病学];
摘要
Purpose We aimed to study the relationship between two morphological parameters recently described on MRI images in relation to lumbar spinal stenosis (LSS): the first is the sedimentation sign (SedS) and the second is the morphological grading of lumbar stenosis. Materials and methods MRIs from a total of 137 patients were studied. From those, 110 were issued from a prospective database of symptomatic LSS patients, of whom 73 were treated surgically and 37 conservatively based on symptom severity. A third group consisting of 27 subjects complaining of low back pain (LBP) served as control. Severity of stenosis was judged at disc level using the four A to D grade morphological classification. The presence of a SedS was judged at pedicle level, above or below the site of maximal stenosis. Results A positive SedS was observed in 58, 69 and 76 % of patients demonstrating B, C and D morphology, respectively, but in none with grade A morphology. The SedS was positive in 67 and 35 % of the surgically and conservatively treated patients, respectively, and in 8 % of the LBP group. C and D morphological grades were present in 97 and 35 % of patients in the surgically and conservatively treated group, respectively, and in 18 % of the LBP group. Presence of a positive SedS carried an increased risk of being submitted to surgery in the symptomatic LSS group (OR 3.5). This risk was even higher in the LSS patients demonstrating grade C or D morphology (OR 65). Discussion and conclusion One-third of surgically treated LSS patients do not present a SedS. This sign appears to be a lesser predictor of treatment modality in our setting of symptomatic LSS patients compared to the severity of stenosis judged by the morphological grade.
引用
收藏
页码:2264 / 2268
页数:5
相关论文
共 12 条
[1]
Nerve Root Sedimentation Sign Evaluation of a New Radiological Sign in Lumbar Spinal Stenosis [J].
Barz, Thomas ;
Melloh, Markus ;
Staub, Lukas P. ;
Lord, Sarah J. ;
Lange, Joern ;
Roeder, Christoph P. ;
Theis, Jean-Claude ;
Merk, Harry R. .
SPINE, 2010, 35 (08) :892-897
[2]
Does the presence of the nerve root sedimentation sign on MRI correlate with the operative level in patients undergoing posterior lumbar decompression for lumbar stenosis? [J].
Fazal, Akil ;
Yoo, Andrew ;
Bendo, John A. .
SPINE JOURNAL, 2013, 13 (08) :837-842
[3]
Associations between radiographic lumbar spinal stenosis and clinical symptoms in the general population: the Wakayama Spine Study [J].
Ishimoto, Y. ;
Yoshimura, N. ;
Muraki, S. ;
Yamada, H. ;
Nagata, K. ;
Hashizume, H. ;
Takiguchi, N. ;
Minamide, A. ;
Oka, H. ;
Kawaguchi, H. ;
Nakamura, K. ;
Akune, T. ;
Yoshida, M. .
OSTEOARTHRITIS AND CARTILAGE, 2013, 21 (06) :783-788
[4]
DOES DEGENERATIVE DISEASE OF THE LUMBAR SPINE CAUSE ARACHNOIDITIS - A MAGNETIC-RESONANCE STUDY AND REVIEW OF THE LITERATURE [J].
JACKSON, A ;
ISHERWOOD, I .
BRITISH JOURNAL OF RADIOLOGY, 1994, 67 (801) :840-847
[5]
Factors influencing the surgical decision for the treatment of degenerative lumbar stenosis in a preference-based shared decision-making process [J].
Kim, Ho-Joong ;
Park, Jae-Young ;
Kang, Kyoung-Tak ;
Chang, Bong-Soon ;
Lee, Choon-Ki ;
Yeom, Jin S. .
EUROPEAN SPINE JOURNAL, 2015, 24 (02) :339-347
[6]
Patterns of chronic adhesive arachnoiditis following Myodil myelography: The significance of spinal canal stenosis and previous surgery [J].
Laitt, R ;
Jackson, A ;
Isherwood, I .
BRITISH JOURNAL OF RADIOLOGY, 1996, 69 (824) :693-698
[7]
The Sedimentation Sign for Differential Diagnosis of Lumbar Spinal Stenosis [J].
Macedo, Luciana Gazzi ;
Wang, Yue ;
Battie, Michele C. .
SPINE, 2013, 38 (10) :827-831
[8]
Decision-making in lumbar spinal stenosis A SURVEY ON THE INFLUENCE OF THE MORPHOLOGY OF THE DURAL SAC [J].
Schizas, C. ;
Kulik, G. .
JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME, 2012, 94B (01) :98-101
[9]
Qualitative Grading of Severity of Lumbar Spinal Stenosis Based on the Morphology of the Dural Sac on Magnetic Resonance Images [J].
Schizas, Constantin ;
Theumann, Nicolas ;
Burn, Alexandre ;
Tansey, Rosamond ;
Wardlaw, Douglas ;
Smith, Francis W. ;
Kulik, Gerit .
SPINE, 2010, 35 (21) :1919-1924
[10]
THE PATHOMORPHOLOGY OF SPINAL STENOSIS AS SEEN ON CT SCANS OF THE LUMBAR SPINE [J].
SCHONSTROM, NSR ;
BOLENDER, NF ;
SPENGLER, DM .
SPINE, 1985, 10 (09) :806-811