Azimi Parisa, Yazdanian Taravat, Benzel Edward C
Functional Neurosurgery Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Medicine, Capital Medical University, Beijing, China.
Asian Spine J. 2017 Aug;11(4):580-585. doi: 10.4184/asj.2017.11.4.580. Epub 2017 Aug 7.
Cross-sectional.
To examine the relationship between magnetic resonance imaging (MRI) morphology stenosis grades and preoperative walking ability in patients with lumbar canal stenosis (LCS).
No previous study has analyzed the correlation between MRI morphology stenosis grades and walking ability in patients with LCS.
This prospective study included 98 consecutive patients with LCS who were candidates for surgery. Using features identified in T2-weighted axial magnetic, stenosis type was determined at the maximal stenosis level, and only trefoil and triangle stenosis grade types were considered because of sufficient sample size. Intraobserver and interobserver reliability were assessed by calculating weighted kappa coefficients. Symptom severity was evaluated via the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ). Walking ability was assessed using the Self-Paced Walking Test (SPWT) and JOABPEQ subscales. Demographic characteristics, SPWT scores, and JOABPEQ scores were compared between patients with trefoil and triangle stenosis types.
The mean patient age was 58.1 (standard deviation, 8.4) years. The kappa values of the MRI morphology stenosis grade types showed a perfect agreement between the stenosis grade types. The trefoil group (n=53) and triangle group (n=45) showed similar preoperative JOABPEQ subscale scores (e.g., low back pain, lumbar function, and mental health) and were not significantly different in age, BMI, duration of symptoms, or lumbar stenosis levels (all >0.05); however, trefoil stenosis grade type was associated with a decreased walking ability according to the SPWT and JOABPEQ subscale scores.
These findings suggest preoperative walking ability is more profoundly affected in patients with trefoil type stenosis than in those with triangle type stenosis.
横断面研究。
探讨腰椎管狭窄症（LCS）患者的磁共振成像（MRI）形态学狭窄分级与术前步行能力之间的关系。
既往尚无研究分析LCS患者MRI形态学狭窄分级与步行能力之间的相关性。
这项前瞻性研究纳入了98例连续的LCS患者，这些患者均为手术候选者。利用T2加权轴向磁共振成像所识别的特征，在最大狭窄水平确定狭窄类型，由于样本量充足，仅考虑三叶形和三角形狭窄分级类型。通过计算加权kappa系数评估观察者内和观察者间的可靠性。通过日本骨科协会背痛评估问卷（JOABPEQ）评估症状严重程度。使用自定步速行走测试（SPWT）和JOABPEQ分量表评估步行能力。比较三叶形和三角形狭窄类型患者的人口统计学特征、SPWT评分和JOABPEQ评分。
患者的平均年龄为58.1（标准差，8.4）岁。MRI形态学狭窄分级类型的kappa值显示狭窄分级类型之间具有完美一致性。三叶形组（n = 53）和三角形组（n = 45）术前JOABPEQ分量表评分相似（例如，腰痛、腰椎功能和心理健康），在年龄、体重指数、症状持续时间或腰椎狭窄程度方面无显著差异（均>0.05）；然而，根据SPWT和JOABPEQ分量表评分，三叶形狭窄分级类型与步行能力下降相关。
这些发现表明，与三角形狭窄类型的患者相比，三叶形狭窄类型的患者术前步行能力受到的影响更大。
