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. 2014 Sep 17;9(9):e106404.
doi: 10.1371/journal.pone.0106404. eCollection 2014.

Preoperative MRI findings predict two-year postoperative clinical outcome in lumbar spinal stenosis

Pekka Kuittinen  1 , Petri Sipola  2 , Ville Leinonen  3 , Tapani Saari  4 , Sanna Sinikallio  5 , Sakari Savolainen  6 , Heikki Kröger  7 , Veli Turunen  8 , Olavi Airaksinen  9 , Timo Aalto  10
Affiliations

Preoperative MRI findings predict two-year postoperative clinical outcome in lumbar spinal stenosis

Pekka Kuittinen et al. PLoS One. .

Abstract

Purpose: To study the predictive value of preoperative magnetic resonance imaging (MRI) findings for the two-year postoperative clinical outcome in lumbar spinal stenosis (LSS).

Methods: 84 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.

Results: Preoperative 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.

Conclusions: Routine 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.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Visual analogue pain (mean ± SD) on two-year follow-up in patients with moderate and severe central spinal stenosis in visual analysis of lumbar spine magnetic resonance images.
See this image and copyright information in PMC

References

    1. North American Spine Society (NASS) (2011) Diagnosis and treatment of degenerative lumbar spinal stenosis. Burr Ridge (IL): North American Spine Society (NASS).
    1. Wunschmann BW, Sigl T, Ewert T, Schwarzkopf SR, Stucki G (2003) Physical therapy to treat spinal stenosis. Orthopade 32: 865–868. - PubMed
    1. Deyo RA, Mirza SK, Martin BI, Kreuter W, Goodman DC, et al. (2010) Trends, major medical complications, and charges associated with surgery for lumbar spinal stenosis in older adults. JAMA 303: 1259–1265. - PMC - PubMed
    1. Atlas SJ, Keller RB, Wu YA, Deyo RA, Singer DE (2005) Long-term outcomes of surgical and nonsurgical management of lumbar spinal stenosis: 8 to 10 year results from the maine lumbar spine study. Spine (Phila Pa 1976) 30: 936–943. - PubMed
    1. Aalto T, Sinikallio S, Kroger H, Viinamaki H, Herno A, et al. (2012) Preoperative predictors for good postoperative satisfaction and functional outcome in lumbar spinal stenosis surgery - a prospective observational study with a two-year follow-up. Scand J Surg 101: 255–260. - PubMed

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