Department of Orthopedic Surgery, Ålesund Hospital, Møre and Romsdal Hospital Trust, Ålesund, Norway.
Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Eur Spine J. 2022 Jun;31(6):1391-1398. doi: 10.1007/s00586-021-07051-4. Epub 2021 Nov 19.
The aim was to describe magnetic resonance imaging findings in patients planned for lumbar spinal stenosis surgery. Further, to describe possible associations between MRI findings and patient characteristics with patient reported disability or pain.
The NORDSTEN spinal stenosis trial included 437 patients planned for surgical decompression of LSS. The following MRI findings were evaluated before surgery: morphological (Schizas) and quantitative (cross-sectional area) grade of stenosis, disk degeneration (Pfirrmann), facet joint tropism and fatty infiltration of the multifidus muscle. Patients were dichotomized into a moderate or severe category for each radiological parameter classification. A multivariable linear regression analysis was performed to investigate the association between MRI findings and preoperative scores for Oswestry Disability Index, Zurich Claudication Questionnaire and Numeric rating scale for back and leg pain. The following patient characteristics were included in the analysis: gender, age, smoking and weight.
The percentage of patients with severe scores was as follows: Schizas (C + D) 71.3%, cross-sectional area (< 75 mm) 86.8%, Pfirrmann (4 + 5) 58.1%, tropism (≥ 15°) 11.9%, degeneration of multifidus muscle (2-4) 83.7%. Regression coefficients indicated minimal changes in severity of symptoms when comparing the groups with moderate and severe MRI findings. Only gender had a significant and clinically relevant association with ODI score.
In this cross-sectional study, the majority of the patients had MRI findings classified as severe LSS changes, but the findings had no clinically relevant association with patient reported disability and pain at baseline. Patient characteristics have a larger impact on disability and pain than radiological findings.
www.
gov identifier: NCT02007083, registered December 2013.
描述计划行腰椎管狭窄症手术患者的磁共振成像（MRI）表现。进一步描述 MRI 表现与患者特征（包括患者报告的残疾或疼痛）之间的可能关联。
NORDSTEN 腰椎管狭窄症试验纳入了 437 例行腰椎管狭窄减压手术的患者。在手术前评估了以下 MRI 表现：形态学（Schizas）和定量（横截面积）狭窄程度、椎间盘退变（Pfirrmann）、关节突关节倾斜和多裂肌脂肪浸润。患者按照每种影像学参数分类的中度或重度进行分类。采用多元线性回归分析来探讨 MRI 表现与术前 Oswestry 功能障碍指数（ODI）评分、苏黎世间歇性跛行问卷（Zurich Claudication Questionnaire）和腰背腿痛数字评分量表（Numeric rating scale for back and leg pain）之间的相关性。分析中纳入了以下患者特征：性别、年龄、吸烟和体重。
严重评分患者的比例如下：Schizas（C + D）71.3%、横截面积（＜75mm）86.8%、Pfirrmann（4 + 5）58.1%、倾斜度（≥15°）11.9%、多裂肌退变（2-4）83.7%。当比较 MRI 表现为中度和重度的两组时，回归系数表明症状严重程度的变化很小。只有性别与 ODI 评分具有显著的、临床相关的关联。
在这项横断面研究中，大多数患者的 MRI 表现均为严重的腰椎管狭窄改变，但这些表现与基线时患者报告的残疾和疼痛无临床相关关联。患者特征对残疾和疼痛的影响大于影像学表现。
www.。
gov 标识符：NCT02007083，于 2013 年 12 月注册。
