Goni Vijay G, Hampannavar Aravind, Gopinathan Nirmal Raj, Singh Paramjeet, Sudesh Pebam, Logithasan Rajesh Kumar, Sharma Anurag, Bk Shashidhar, Sament Radheshyam
Department of Orthopaedics, PostGraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Radiology, PostGraduate Institute of Medical Education and Research, Chandigarh, India.
Asian Spine J. 2014 Feb;8(1):44-50. doi: 10.4184/asj.2014.8.1.44. Epub 2014 Feb 6.
Cross-sectional study.
The aim of the study was to determine relationship between the degrees of radiologically demonstrated anatomical lumbar canal stenosis using magnetic resonance imaging (MRI) and its correlation with the patient's disability level, using the Oswestry Disability Index (ODI).
The relationship between the imaging studies and clinical symptoms has been uncertain in patients suffering from symptomatic lumbar canal stenosis. There is a limited number of studies which correlates the degree of stenosis with simple reproducible scoring methods.
Fifty patients were selected from 350 patients who fulfilled the inclusion criteria. The patients answered the national-language translated form of ODI. The ratio of disability was interpreted, and the patients were grouped accordingly. They were subjected to MRI; and the anteroposterior diameters of the lumbar intervertebral disc spaces and the thecal sac cross sectional area were measured. Comparison was performed between the subdivisions of the degree of lumbar canal stenosis, based on the following: anteroposterior diameter (three groups: normal, relative stenosis and absolute stenosis); subdivisions of the degree of central canal stenosis, based on the thecal sac cross-sectional area, measured on axial views (three groups: normal, moderately stenotic and severely stenotic); and the ODI outcome, which was also presented in 20 percentiles.
No significant correlation was established between the radiologically depicted anatomical lumbar stenosis and the Oswestry Disability scores.
Magnetic resonance imaging alone should not be considered in isolation when assessing and treating patients diagnosed with lumbar canal stenosis.
横断面研究。
本研究旨在通过磁共振成像(MRI)确定影像学显示的腰椎管狭窄程度与患者残疾水平之间的关系,并使用奥斯威斯功能障碍指数(ODI)进行相关性分析。
对于有症状的腰椎管狭窄患者,影像学检查与临床症状之间的关系尚不确定。仅有少数研究将狭窄程度与简单可重复的评分方法相关联。
从350例符合纳入标准的患者中选取50例。患者回答ODI的国语翻译版问卷。解读残疾比例,并据此对患者进行分组。对患者进行MRI检查;测量腰椎间盘间隙的前后径和硬膜囊横截面积。基于以下因素对腰椎管狭窄程度的亚组进行比较:前后径(三组:正常、相对狭窄和绝对狭窄);基于轴位视图测量的硬膜囊横截面积对中央管狭窄程度的亚组(三组:正常、中度狭窄和重度狭窄);以及同样以20百分位数呈现的ODI结果。
影像学显示的解剖学腰椎狭窄与奥斯威斯功能障碍评分之间未建立显著相关性。
在评估和治疗诊断为腰椎管狭窄的患者时,不应单独考虑磁共振成像结果。