Wegdell Gustav, Albarni Abdulrahman, Åkerstedt Josefin, Endler Peter, Gerdhem Paul, Själander Anders, Mukka Sebastian, Knutsson Björn
Department of Diagnostics and Intervention, Umeå University, Umeå, Sweden.
RKC Spine Center, Södra Fiskartorpsvägen 15H, 11433 Stockholm, Stockholm, Sweden.
Eur Spine J. 2025 Jun 12. doi: 10.1007/s00586-025-09049-8.
To validate the Swedish National Spine Registry (Swespine) for diagnostic accuracy and documentation of surgical procedures for central lumbar spinal stenosis (CLSS) and lumbar disc herniation (LDH), including an analysis of preoperative magnetic resonance imaging (MRI). Additionally, this study evaluates the accuracy and completeness of perioperative data and documented complications.
Of 41,312 patients registered in Swespine for CLSS or LDH between January 2017 and December 2022, 800 were randomly selected from four hospitals. The electronic patient records were used as the gold standard. Radiological criteria for CLSS and LDH were established through a review of MRI scans.
The proportion of correctly classified diagnoses (PCC) was 98.5% for CLSS and 99.2% for LDH, while the PCC of the type of surgery was 99.7% and 98.5% in the CLSS and LDH cohorts, respectively. Preoperative MRI analysis showed that 94.2% of patients undergoing CLSS surgery at the narrowest spinal level were classified as Schizas C or D, with a mean cross-sectional area of 44.2 mm². In comparison, 85.0% of patients who underwent LDH surgery were classified with Pfirrman grade 3.
Swespine demonstrated high accuracy and completeness in diagnosing and surgically treating CLSS and LDH patients, as corroborated by preoperative MRI assessments. Most perioperative data, including complications, demonstrated acceptable to excellent registration. Improvements are recommended in the documentation of the American Society of Anaesthesiologists classification, patient weight and height, smoking status, use of implants and bone grafts, date of discharge, use of thromboprophylaxis, and previous surgeries.
验证瑞典国家脊柱登记处（Swespine）在诊断中央腰椎管狭窄症（CLSS）和腰椎间盘突出症（LDH）的准确性以及手术记录方面的情况，包括对术前磁共振成像（MRI）的分析。此外，本研究评估围手术期数据的准确性和完整性以及记录的并发症。
在2017年1月至2022年12月期间在Swespine登记的41312例CLSS或LDH患者中，从四家医院随机选取800例。将电子病历用作金标准。通过对MRI扫描的回顾确定CLSS和LDH的放射学标准。
CLSS的正确分类诊断比例（PCC）为98.5%，LDH为99.2%，而CLSS和LDH队列中手术类型的PCC分别为99.7%和98.5%。术前MRI分析显示，在最狭窄脊柱节段接受CLSS手术的患者中，94.2%被分类为Schizas C或D，平均横截面积为44.2平方毫米。相比之下，接受LDH手术的患者中有85.0%被分类为Pfirrman 3级。
正如术前MRI评估所证实的那样，Swespine在诊断和手术治疗CLSS和LDH患者方面显示出高准确性和完整性。大多数围手术期数据，包括并发症，显示出可接受至优秀的记录水平。建议在麻醉医师协会分类、患者体重和身高、吸烟状况、植入物和骨移植的使用、出院日期、血栓预防措施的使用以及既往手术的记录方面进行改进。
