Relationship between sedimentation sign and morphological grade in symptomatic lumbar spinal stenosis.
Détails
ID Serval
serval:BIB_B669C6B1C586
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Relationship between sedimentation sign and morphological grade in symptomatic lumbar spinal stenosis.
Périodique
European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
ISSN
1432-0932 (Electronic)
ISSN-L
0940-6719
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
24
Numéro
10
Pages
2264-2268
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Résumé
PURPOSE: We aimed to study the relationship between two morphological parameters recently described on MRI images in relation to lumbar spinal stenosis (LSS): the first is the sedimentation sign (SedS) and the second is the morphological grading of lumbar stenosis.
MATERIALS AND METHODS: MRIs from a total of 137 patients were studied. From those, 110 were issued from a prospective database of symptomatic LSS patients, of whom 73 were treated surgically and 37 conservatively based on symptom severity. A third group consisting of 27 subjects complaining of low back pain (LBP) served as control. Severity of stenosis was judged at disc level using the four A to D grade morphological classification. The presence of a SedS was judged at pedicle level, above or below the site of maximal stenosis.
RESULTS: A positive SedS was observed in 58, 69 and 76% of patients demonstrating B, C and D morphology, respectively, but in none with grade A morphology. The SedS was positive in 67 and 35% of the surgically and conservatively treated patients, respectively, and in 8% of the LBP group. C and D morphological grades were present in 97 and 35% of patients in the surgically and conservatively treated group, respectively, and in 18% of the LBP group. Presence of a positive SedS carried an increased risk of being submitted to surgery in the symptomatic LSS group (OR 3.5). This risk was even higher in the LSS patients demonstrating grade C or D morphology (OR 65).
DISCUSSION AND CONCLUSION: One-third of surgically treated LSS patients do not present a SedS. This sign appears to be a lesser predictor of treatment modality in our setting of symptomatic LSS patients compared to the severity of stenosis judged by the morphological grade.
MATERIALS AND METHODS: MRIs from a total of 137 patients were studied. From those, 110 were issued from a prospective database of symptomatic LSS patients, of whom 73 were treated surgically and 37 conservatively based on symptom severity. A third group consisting of 27 subjects complaining of low back pain (LBP) served as control. Severity of stenosis was judged at disc level using the four A to D grade morphological classification. The presence of a SedS was judged at pedicle level, above or below the site of maximal stenosis.
RESULTS: A positive SedS was observed in 58, 69 and 76% of patients demonstrating B, C and D morphology, respectively, but in none with grade A morphology. The SedS was positive in 67 and 35% of the surgically and conservatively treated patients, respectively, and in 8% of the LBP group. C and D morphological grades were present in 97 and 35% of patients in the surgically and conservatively treated group, respectively, and in 18% of the LBP group. Presence of a positive SedS carried an increased risk of being submitted to surgery in the symptomatic LSS group (OR 3.5). This risk was even higher in the LSS patients demonstrating grade C or D morphology (OR 65).
DISCUSSION AND CONCLUSION: One-third of surgically treated LSS patients do not present a SedS. This sign appears to be a lesser predictor of treatment modality in our setting of symptomatic LSS patients compared to the severity of stenosis judged by the morphological grade.
Mots-clé
Humans, Lumbar Vertebrae/physiopathology, Magnetic Resonance Imaging, Prospective Studies, Spinal Stenosis/classification, Spinal Stenosis/diagnosis
Pubmed
Web of science
Création de la notice
27/10/2015 18:26
Dernière modification de la notice
20/08/2019 16:24