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Qualitative Grading as a Tool in the Management of Multilevel Lumbar Spine Stenosis
STUDY DESIGN: This is a prospective study that was undertaken at a single centre and involved 80 consecutive patients diagnosed with lumbar spinal stenosis (LSS). PURPOSE: The aim of the study was to assess the efficacy of a qualitative grading system as seen on magnetic resonance imaging (MRI) as a...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Korean Society of Spine Surgery
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401843/ https://www.ncbi.nlm.nih.gov/pubmed/28443173 http://dx.doi.org/10.4184/asj.2017.11.2.278 |
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author | Soman, Shardul Madhav Chokshi, Jimmy Chhatrala, Naitik Tharadara, Gulam Haider Prabhakar, Mukund |
author_facet | Soman, Shardul Madhav Chokshi, Jimmy Chhatrala, Naitik Tharadara, Gulam Haider Prabhakar, Mukund |
author_sort | Soman, Shardul Madhav |
collection | PubMed |
description | STUDY DESIGN: This is a prospective study that was undertaken at a single centre and involved 80 consecutive patients diagnosed with lumbar spinal stenosis (LSS). PURPOSE: The aim of the study was to assess the efficacy of a qualitative grading system as seen on magnetic resonance imaging (MRI) as a tool in the management of multilevel LSS. OVERVIEW OF LITERATURE: LSS diagnosis is clinical but is usually radiologically supplemented. However, there are often multilevel radiological findings with non-specific or atypical clinical features. We used a qualitative grading system to help in the decision-making process of the management of patients with multilevel LSS. METHODS: 80 patients with LSS were treated with decompression and prospectively followed-up for a minimum of 12 months. All had failed conservative treatment. Qualitative grading of LSS severity was based on the dural sac in T2 weighted axial MRI images at all disc levels and was done from L1–2 to L5–S1 (n=400). Functional outcome was assessed using the Oswestry disability index (ODI). RESULTS: The mean patient age was 56.6 years, with a gender ratio of 0.6:1. Forty patients had degenerative LSS and 40 had degenerative spondylolysthesis. A total of 178 levels were decompressed, the majority of which were L4–L5 (43.82%), followed by L5–S1 (41.57%). According to our qualitative grading system, grade D stenosis (53.93%) was decompressed most frequently, followed by grade C stenosis (41.57%). The average preoperative ODI score was 58.55%, which later reduced to 19.15%. Seventy percent of patients achieved excellent results, whereas 30% achieved good results. CONCLUSIONS: Morphological grading is a useful tool in decision making in surgery for multilevel LSS. Grade C and D stenosis should be decompressed, whereas A and B should not be, unless clinically justified. |
format | Online Article Text |
id | pubmed-5401843 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Korean Society of Spine Surgery |
record_format | MEDLINE/PubMed |
spelling | pubmed-54018432017-04-25 Qualitative Grading as a Tool in the Management of Multilevel Lumbar Spine Stenosis Soman, Shardul Madhav Chokshi, Jimmy Chhatrala, Naitik Tharadara, Gulam Haider Prabhakar, Mukund Asian Spine J Clinical Study STUDY DESIGN: This is a prospective study that was undertaken at a single centre and involved 80 consecutive patients diagnosed with lumbar spinal stenosis (LSS). PURPOSE: The aim of the study was to assess the efficacy of a qualitative grading system as seen on magnetic resonance imaging (MRI) as a tool in the management of multilevel LSS. OVERVIEW OF LITERATURE: LSS diagnosis is clinical but is usually radiologically supplemented. However, there are often multilevel radiological findings with non-specific or atypical clinical features. We used a qualitative grading system to help in the decision-making process of the management of patients with multilevel LSS. METHODS: 80 patients with LSS were treated with decompression and prospectively followed-up for a minimum of 12 months. All had failed conservative treatment. Qualitative grading of LSS severity was based on the dural sac in T2 weighted axial MRI images at all disc levels and was done from L1–2 to L5–S1 (n=400). Functional outcome was assessed using the Oswestry disability index (ODI). RESULTS: The mean patient age was 56.6 years, with a gender ratio of 0.6:1. Forty patients had degenerative LSS and 40 had degenerative spondylolysthesis. A total of 178 levels were decompressed, the majority of which were L4–L5 (43.82%), followed by L5–S1 (41.57%). According to our qualitative grading system, grade D stenosis (53.93%) was decompressed most frequently, followed by grade C stenosis (41.57%). The average preoperative ODI score was 58.55%, which later reduced to 19.15%. Seventy percent of patients achieved excellent results, whereas 30% achieved good results. CONCLUSIONS: Morphological grading is a useful tool in decision making in surgery for multilevel LSS. Grade C and D stenosis should be decompressed, whereas A and B should not be, unless clinically justified. Korean Society of Spine Surgery 2017-04 2017-04-12 /pmc/articles/PMC5401843/ /pubmed/28443173 http://dx.doi.org/10.4184/asj.2017.11.2.278 Text en Copyright © 2017 by Korean Society of Spine Surgery http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Clinical Study Soman, Shardul Madhav Chokshi, Jimmy Chhatrala, Naitik Tharadara, Gulam Haider Prabhakar, Mukund Qualitative Grading as a Tool in the Management of Multilevel Lumbar Spine Stenosis |
title | Qualitative Grading as a Tool in the Management of Multilevel Lumbar Spine Stenosis |
title_full | Qualitative Grading as a Tool in the Management of Multilevel Lumbar Spine Stenosis |
title_fullStr | Qualitative Grading as a Tool in the Management of Multilevel Lumbar Spine Stenosis |
title_full_unstemmed | Qualitative Grading as a Tool in the Management of Multilevel Lumbar Spine Stenosis |
title_short | Qualitative Grading as a Tool in the Management of Multilevel Lumbar Spine Stenosis |
title_sort | qualitative grading as a tool in the management of multilevel lumbar spine stenosis |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5401843/ https://www.ncbi.nlm.nih.gov/pubmed/28443173 http://dx.doi.org/10.4184/asj.2017.11.2.278 |
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