Otani Koji, Kikuchi Shin-Ichi, Nikaido Takuya, Konno Shin-Ichi
Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima 960-1295, Japan.
J Clin Med. 2022 Jun 25;11(13):3668. doi: 10.3390/jcm11133668.
Lumbar spinal stenosis (LSS) is a clinical syndrome based on anatomic narrowing of the spinal canal. It is well known that anatomic narrowing of the spinal canal is essential for manifestation, but not all of them cause symptoms. There are many studies assessing the relationship between dural tube compression on MRI and clinical symptoms; however, most of them are cross-sectional. The purpose of this study was to reveal the magnitude of dural tube compression's influence on the presence or development of LSS symptoms at the six-year follow-up and the occurrence of surgery during the follow-up period or not in the community setting.
This was a longitudinal observational study of 459 participants who were assessed for typical LSS symptoms, and whose Roland-Morris Disability Questionnaire and numerical rating scale of leg pain and numbness was recorded using a questionnaire and conventional MRI of the lumbar spine. Typical LSS symptoms were judged using an LSS diagnostic support tool, which was a self-administered, self-reported history questionnaire (LSS-SSHQ). After six years, 232 subjects (follow-up rate 50.5%) were followed-up with typical LSS symptoms using LSS-SSHQ by mail. The relationship between the magnitude of dural tube compression evaluated by dural tube cross-sectional area (DCSA) in the initial assessment and the time course of typical LSS symptoms for the six-year duration were analyzed. In addition, predictors of the presence of typical LSS symptoms at the six-year follow-up were assessed. Furthermore, we investigated the relationship between typical LSS symptoms and DCSA during the initial assessment of patients who underwent surgery during the follow-up period. A multivariate logistic regression analysis was performed for statistical analysis.
(1) Severe dural tube compression did not show that LSS symptoms continued after six years. (2) Severe dural tube compression could not detect development of LSS-symptoms and surgery during the six-year period.
Severe dural tube compression could not detect typical LSS symptom development and occurrence of surgery during the six-year period.
腰椎管狭窄症（LSS）是一种基于椎管解剖性狭窄的临床综合征。众所周知，椎管的解剖性狭窄是其表现的必要条件，但并非所有狭窄都会导致症状。有许多研究评估了MRI上硬膜囊受压与临床症状之间的关系；然而，其中大多数是横断面研究。本研究的目的是揭示在社区环境中，六年随访期间硬膜囊受压对LSS症状的出现或发展以及随访期间手术发生情况的影响程度。
这是一项对459名参与者的纵向观察性研究，这些参与者接受了典型LSS症状的评估，并使用问卷记录了他们的罗兰-莫里斯残疾问卷以及腿痛和麻木的数字评分量表，同时进行了腰椎常规MRI检查。使用LSS诊断支持工具判断典型LSS症状，该工具是一份自我管理、自我报告病史的问卷（LSS-SSHQ）。六年后，通过邮件使用LSS-SSHQ对232名有典型LSS症状的受试者（随访率50.5%）进行随访。分析了初始评估中通过硬膜囊横截面积（DCSA）评估的硬膜囊受压程度与六年期间典型LSS症状的时间进程之间的关系。此外，评估了六年随访时典型LSS症状存在的预测因素。此外，我们还研究了随访期间接受手术的患者在初始评估时典型LSS症状与DCSA之间的关系。进行多因素逻辑回归分析以进行统计分析。
（1）严重硬膜囊受压并未显示六年后LSS症状仍持续存在。（2）严重硬膜囊受压在六年期间未检测到LSS症状的发展和手术情况。
严重硬膜囊受压在六年期间未检测到典型LSS症状的发展和手术的发生。
