Andrasinova Tereza, Adamova Blanka, Buskova Jana, Kerkovsky Milos, Jarkovsky Jiri, Bednarik Josef
Department of Neurology, University Hospital and Masaryk University Brno, Jihlavska.
CEITEC-Central European Institute of Technology, Masaryk University Brno, Kamenice.
Clin Spine Surg. 2018 Oct;31(8):E403-E408. doi: 10.1097/BSD.0000000000000681.
This was an observational cross-sectional study.
The purpose of this study was to evaluate whether the degree of stenosis on magnetic resonance imaging (MRI) relates to the severity of clinical symptoms, disability, or neurological deficit in patients with symptomatic central lumbar spinal stenosis (LSS).
The relationship between radiologic findings and the clinical manifestations of LSS remains unclear.
A total of 84 patients (42 men, median age 70 y) with neurogenic claudication and central degenerative LSS were included in the study. The MRI parameters describing severity (anteroposterior diameter of dural sac, cross-sectional area of the dural sac, stenosis ratio, and Schizas qualitative morphologic classification were evaluated at maximum stenotic level) and the extent of stenosis (the number of central stenotic levels) were correlated to symptoms (pain intensity, walking capacity), functional disability (measured in terms of the Oswestry Disability Index), and neurological signs of LSS (neurological status was evaluated and scored by Neurological Impairment Score in LSS).
A statistically significant correlation emerged only between the Neurological Impairment Score in LSS and Schizas morphologic classification (P=0.006). Pain intensity, walking capacity, and functional disability displayed no correlation with the MRI parameters of LSS.
LSS is a clinicoradiologic syndrome with complex relationships between degree of radiologic stenosis disclosed by MRI and clinical manifestations. Neurological impairment in the lower extremities reflects the degree of morphologic LSS on MRI. This study did not identify any association between the degree of stenosis and functional disability, pain intensity, or walking capacity.
Level II.
这是一项观察性横断面研究。
本研究的目的是评估磁共振成像（MRI）上的狭窄程度是否与有症状的中央型腰椎管狭窄症（LSS）患者的临床症状严重程度、残疾程度或神经功能缺损相关。
LSS的影像学表现与临床表现之间的关系仍不明确。
本研究纳入了84例患有神经源性间歇性跛行和中央型退行性LSS的患者（42例男性，中位年龄70岁）。在最大狭窄水平评估描述严重程度的MRI参数（硬膜囊前后径、硬膜囊横截面积、狭窄率和Schizas定性形态学分类）以及狭窄范围（中央狭窄节段数），并将其与症状（疼痛强度、步行能力）、功能残疾（以Oswestry残疾指数衡量）和LSS的神经体征（通过LSS神经损伤评分评估和评分神经状态）进行相关性分析。
仅在LSS神经损伤评分与Schizas形态学分类之间出现了统计学上的显著相关性（P = 0.006）。疼痛强度、步行能力和功能残疾与LSS的MRI参数无相关性。
LSS是一种临床放射学综合征，MRI显示的放射学狭窄程度与临床表现之间存在复杂关系。下肢神经损伤反映了MRI上LSS的形态学程度。本研究未发现狭窄程度与功能残疾、疼痛强度或步行能力之间存在任何关联。
二级。
