scholarly journals Influence of Lumbar Spinal Canal Dimensions on Neurological Claudication Symptomatology - A Case Control Study

2021 ◽  
Vol 14 (02) ◽  
pp. 1019-1024
Author(s):  
Monika Reddy ◽  
Dr Ranganath Gangavelli ◽  
Priyanka Priyanka ◽  
Dr P Saikiran
Keyword(s):  
Spinal Canal ◽  
Clinical Symptoms ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Lateral Recess ◽  
Dural Sac ◽  
Lumbar Spinal Canal ◽  
Lumbar Spinal ◽  
Mri Measurements

Lumbar spinal stenosis (LSS) is abnormal narrowing of spinal canal of lumbar vertebrae causing compression of neural tissue which leads to a neurologic deficit. LSS is diagnosed based on clinical symptoms of patient and it is confirmed using MRI (Magnetic Resonance Imaging). The aim of the study is to determine the association between MRI lumbar spinal canal and foraminal dimensions in on neurological claudication symptomology. A total of 89 patients (45 males ,44 females, age range: 20-60 years) referred for MRI Lumbar spine were included in this prospective study. Patients were categorized into symptomatic (49 cases) and asymptomatic (40 controls) based on Edinburgh claudication questionnaire (ECQ). The Antero-posterior diameter of dural sac, Transverse diameter of dural sac, Cross sectional area of dural sac, Cross sectional area of lateral recess, Lateral recess depth, Angle of lateral recess, Ligamentous interfacet distance was measured from L3 to S1 on Axial T2 weighted MRI images. The strength of association between MRI measurements and clinical symptoms were assessed using logistic regression analysis and Cramer’s V test. The Phi coefficient value for the lumbar spinal canal, foraminal dimensions with neurogenic claudication symptomology based on ECQ was 0.108 & 0.207 respectively, which showed weak positive correlation. Our study concludes that MRI measurements of lumbar spinal canal and foraminal dimensions denoting LSS were found to show weak positive correlation with clinical symptoms assessed based on Edinburgh claudication questionnaire.

scholarly journals Correlation between severity of spinal stenosis and multifidus atrophy in degenerative lumbar spinal stenosis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Gen Xia ◽  
Xueru Li ◽  
Yanbing Shang ◽  
Bin Fu ◽  
Feng Jiang ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Spinal Canal ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Multifidus Muscle ◽  
Cross Sectional ◽  
Degenerative Lumbar Spinal Stenosis ◽  
Lumbar Spinal ◽  
Muscle Cross Sectional Area

Abstract Background Degenerative lumbar spinal stenosis (DLSS) is a common degenerative condition in older adults. Muscle atrophy (MA) is a leading cause of muscle weakness and disability commonly reported in individuals with spinal stenosis. The purpose of this study was to investigate if the MA correlates with the grade of spinal stenosis in patients with DLSS. Methods A retrospective analysis on 48 male and 184 female DLSS patients aged around 54.04 years (54.04 ± 8.93) were involved and divided into 6 groups according to claudication-distance-based grading of spinal stenosis, which confirmed by two independent orthopedic surgeons using T2- weighted images. Using 1.5T MRI scanner, the severity of MA is assessed based on its negative correlation with the ratio of total fat-free multifidus muscle cross-sectional area (TFCSA) to total multifidus muscle cross-sectional area (TCSA). Adobe Photoshop CS6 was used for qualitative image analysis and calculate the TFCSA/TCSA ratio to assess the severity of MA, compare the grade of MA with the spinal stenosis segment, stenosis grade and symptom side. Results In DLSS group, The TFCSA/TCSA ratio are 74.33 ± 2.18 in L3/4 stenosis, 75.51 ± 2.79 in L4/5 stenosis, and 75.49 ± 2.69 in L5/S1 stenosis. there were significant decreases in the TFCSA/TCSA ratio of stenotic segments compared with non-stenotic segments of the spinal canal (P < 0.05) while no significant difference between the non-stenotic segments (P > 0.05). TFCSA/TCSA ratios is significant differences in the TFCSA/TCSA ratios of the 6 DLSS groups (F = 67.832; P < 0.05). From Group 1 to Group 6, the TFCSA/TCSA ratio of stenotic segments positively correlated with the absolute claudication distance (ACD). (P < 0.001, r = 0.852). Besides, the TFCSA/TCSA ratios are smaller in the symptomatic sides of the spine than the contralateral sides (t = 4.128, P = 0.001). Conclusions The stenotic segments of the spinal canal are more atrophied than the non-stenotic segment in DLSS patients. It is shows that a strong positive correlation between the severity of multifidus atrophy and the severity of spinal stenosis.

scholarly journals Dural Sac Cross-Sectional Area Does Not Correlate with Efficacy of Percutaneous Adhesiolysis in Single Level Lumbar Spinal Stenosis

2011 ◽  
Vol 4;14 (4;7) ◽  
pp. 277-282
Author(s):  
Dr. Chan Hong Park
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Cross Sectional Area ◽  
Low Back ◽  
Sectional Area ◽  
Cross Sectional ◽  
Epidural Steroid Injections ◽  
Dural Sac ◽  
Lumbar Spinal ◽  
Epidural Steroid

Background: Spinal stenosis is a narrowing of the spinal canal, which causes mechanical compression of spinal nerve roots. The compression of these nerve roots can cause low back pain and/or leg pain, as well as neurogenic claudication. Lumbar epidural steroid injections have commonly been used in patients with lumbar spinal stenosis (LSS). In cases that are refractory to epidural steroid injections, percutaneous epidural adhesiolysis has been used. Objective: The aim of our study is to determine the relationship between the severity of spinal stenosis and the participants’ response to adhesiolysis, and to evaluate the mid-term effectiveness of adhesiolysis. Study Design: A prospective observational study. Methods: Sixty-six patients with degenerative LSS were enrolled in this prospective study. All participants underwent lumbar spine magnetic resonance imaging (MRI). The cross-sectional area of the dural sac was measured on the transverse angled sections through the central part of the disc on conventional MR images. All percutaneous adhesiolyses were performed in the operating room. One hour following the procedure, 6 mL of 8% sodium chloride solution was infused during 30 minutes in the recovery room while the patient underwent monitoring. Outcome measures were obtained using the 5-point patient satisfaction scale at 2 weeks and 6 months post-treatment. To evaluate outcome predictors, we divided the participants into 2 groups according to their response to treatment. Limitations: Secondary outcomes were not measured and the study did not include a long-term follow-up period. Results: Improvement (including reports of slightly improved, much improved, and no pain) was observed in 49 participants (74.2%) at 2 weeks and 45 participants (66.7%) at 6 months after the procedure. The dural sac cross-sectional area (DSCSA) did not differ between participants who reported improvement and those who did not. There was no statistically significant correlation between pain relief and DSCSA, age, or participant sex. Conclusion: Percutaneous adhesiolysis was shown to be effective for the treatment of LSS, with mid-term result, without affecting DSCSA. Key words: Low back pain, lumbar spinal stenosis, failed back surgery syndrome, dural sac, interventional techniques, epidural injection, percutaneous adhesiolysis.

Correlation of axial loaded magnetic resonance imaging with clinical symptoms in lumbar spinal canal stenosis patients

MedPharmRes ◽  
2019 ◽  
Vol 2 (4) ◽  
pp. 15-19
Author(s):  
Son Nguyen ◽  
Son Vi ◽  
Hoat Luu ◽  
Toan Do
Keyword(s):  
Spinal Canal ◽  
Clinical Symptoms ◽  
Axial Loading ◽  
Spinal Canal Stenosis ◽  
Leg Pain ◽  
Cross Sectional ◽  
Canal Stenosis ◽  
Conventional Mri ◽  
Frame System ◽  
Lumbar Spinal

There are cases when symptoms are available but no abnormal stenosis is found in MRI and vice versa. Axial-loaded MRI has been shown that it can demonstrate more accurately the real status of spinal canal stenosis than conventional MRI. This is the first time we applied a new system that we have recreated from the original loading frame system in order to fit with the demands of Vietnamese people. Sixty-two patients were selected from Phu Tho Hospital in Phu Tho Province, Vietnam, who fulfilled the inclusion criteria. The Anterior-posterior diameter (APD), Dura Cross-sectional Area (DSCA) in conventional MRI and axial loaded MRI, and changes in APD and DCSA were determined at the single most constricted intervertebral level. The APD and DCSA in axial loaded MRI had very good significant correlations with VAS for back pain (rs=0.83, 0.79), leg pain (rs=0.69, 0.57) and JOA score (rs=0.70, 0.65). APD and DCSA in axial loaded MRI significantly correlated with the severity of symptoms. Our axial loading MRI provides more valuable information than the conventional MRI for assessing patients with LSCS.

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