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Correlation between MRI Grading System and Surgical Findings for Lumbar Foraminal Stenosis

OBJECTIVE: Magnetic resonance imaging (MRI) grading systems using sagittal images are useful for evaluation of lumbar foraminal stenosis. We evaluated whether such a grading system is useful as a diagnostic tool for surgery. METHODS: Between July 2014 and June 2015, 99 consecutive patients underwent...

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Autores principales: Jeong, Tae Seok, Ahn, Yong, Lee, Sang Gu, Kim, Woo Kyung, Son, Seong, Kwon, Jung Hwa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Neurosurgical Society 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5544375/
https://www.ncbi.nlm.nih.gov/pubmed/28689396
http://dx.doi.org/10.3340/jkns.2016.1010.004
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author Jeong, Tae Seok
Ahn, Yong
Lee, Sang Gu
Kim, Woo Kyung
Son, Seong
Kwon, Jung Hwa
author_facet Jeong, Tae Seok
Ahn, Yong
Lee, Sang Gu
Kim, Woo Kyung
Son, Seong
Kwon, Jung Hwa
author_sort Jeong, Tae Seok
collection PubMed
description OBJECTIVE: Magnetic resonance imaging (MRI) grading systems using sagittal images are useful for evaluation of lumbar foraminal stenosis. We evaluated whether such a grading system is useful as a diagnostic tool for surgery. METHODS: Between July 2014 and June 2015, 99 consecutive patients underwent unilateral lumbar foraminotomy for lumbar foraminal stenosis. Surgically confirmed foraminal stenosis and the contralateral, asymptomatic neuroforamen were assessed based on a 4-point MRI grading system. Two experienced researchers independently evaluated the MR sagittal images. Interobserver agreement and intraobserver agreement were analyzed using κ statistics. RESULTS: The mean age of patients (54 women, 45 men) was 62.5 years. A total of 101 levels (202 neuroforamens) were evaluated. MRI grades for operated neuroforamens were as follows: Grade 0 in 0.99%, Grade 1 in 5.28%, Grade 2 in 14.85%, and Grade 3 in 78.88%. Interobserver agreement was moderate for operated neuroforamens (κ=0.511) and good for asymptomatic neuroforamens (κ=0.696). Intraobserver agreement by reader 1 for operated neuroforamens was good (κ=0.776) and that for asymptomatic neuroforamens was very good (κ=0.831). In terms of lumbar level, interobserver agreement for L5–S1 (κ=0.313, fair) was relatively lower than the other level (κ=0.804, very good). CONCLUSION: MRI grading system for lumbar foraminal stenosis is thought to be useful as a diagnostic tool for surgery in the lumbar spine; however, it is less reliable for symptomatic L5–S1 foraminal stenosis than for other levels. Thus, various clinical factors as well as the MRI grading system are required for surgical decision-making.
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spelling pubmed-55443752017-08-09 Correlation between MRI Grading System and Surgical Findings for Lumbar Foraminal Stenosis Jeong, Tae Seok Ahn, Yong Lee, Sang Gu Kim, Woo Kyung Son, Seong Kwon, Jung Hwa J Korean Neurosurg Soc Clinical Article OBJECTIVE: Magnetic resonance imaging (MRI) grading systems using sagittal images are useful for evaluation of lumbar foraminal stenosis. We evaluated whether such a grading system is useful as a diagnostic tool for surgery. METHODS: Between July 2014 and June 2015, 99 consecutive patients underwent unilateral lumbar foraminotomy for lumbar foraminal stenosis. Surgically confirmed foraminal stenosis and the contralateral, asymptomatic neuroforamen were assessed based on a 4-point MRI grading system. Two experienced researchers independently evaluated the MR sagittal images. Interobserver agreement and intraobserver agreement were analyzed using κ statistics. RESULTS: The mean age of patients (54 women, 45 men) was 62.5 years. A total of 101 levels (202 neuroforamens) were evaluated. MRI grades for operated neuroforamens were as follows: Grade 0 in 0.99%, Grade 1 in 5.28%, Grade 2 in 14.85%, and Grade 3 in 78.88%. Interobserver agreement was moderate for operated neuroforamens (κ=0.511) and good for asymptomatic neuroforamens (κ=0.696). Intraobserver agreement by reader 1 for operated neuroforamens was good (κ=0.776) and that for asymptomatic neuroforamens was very good (κ=0.831). In terms of lumbar level, interobserver agreement for L5–S1 (κ=0.313, fair) was relatively lower than the other level (κ=0.804, very good). CONCLUSION: MRI grading system for lumbar foraminal stenosis is thought to be useful as a diagnostic tool for surgery in the lumbar spine; however, it is less reliable for symptomatic L5–S1 foraminal stenosis than for other levels. Thus, various clinical factors as well as the MRI grading system are required for surgical decision-making. Korean Neurosurgical Society 2017-07 2017-07-31 /pmc/articles/PMC5544375/ /pubmed/28689396 http://dx.doi.org/10.3340/jkns.2016.1010.004 Text en Copyright © 2017 The Korean Neurosurgical Society 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 Article
Jeong, Tae Seok
Ahn, Yong
Lee, Sang Gu
Kim, Woo Kyung
Son, Seong
Kwon, Jung Hwa
Correlation between MRI Grading System and Surgical Findings for Lumbar Foraminal Stenosis
title Correlation between MRI Grading System and Surgical Findings for Lumbar Foraminal Stenosis
title_full Correlation between MRI Grading System and Surgical Findings for Lumbar Foraminal Stenosis
title_fullStr Correlation between MRI Grading System and Surgical Findings for Lumbar Foraminal Stenosis
title_full_unstemmed Correlation between MRI Grading System and Surgical Findings for Lumbar Foraminal Stenosis
title_short Correlation between MRI Grading System and Surgical Findings for Lumbar Foraminal Stenosis
title_sort correlation between mri grading system and surgical findings for lumbar foraminal stenosis
topic Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5544375/
https://www.ncbi.nlm.nih.gov/pubmed/28689396
http://dx.doi.org/10.3340/jkns.2016.1010.004
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