Relationship Between Magnetic Resonance Imaging Findings and Clinical Symptoms in Patients with Suspected Lumbar Spinal Canal Stenosis: a Case-control Study.

Abstract

Introduction:Despite the availability of many imaging and clinical criteria for diagnosis of lumbar spinal stenosis (LSS), its correct diagnosis is a challenge for clinicians and radiologists.Aim:The aim of this study was to examine the relationship between magnetic resonance imaging (MRI) findings and clinical symptoms in symptomatic and asymptomatic patients with suspected LSS in MRI.Methods:This study is a case-control study. Two groups of 100 symptomatic and asymptomatic individuals (aged 20 to 84 years) with suspected lumbar spinal canal stenosis who referred to the imaging unit for lumbosacral MRI were included. The clinical symptoms and radiological parameters in MRI for all patients were recorded and relationship between them were evaluated.Results:Among the quantitative imaging findings, only the anterior-posterior diameter of the canal at the level of the intervertebral disc, the central spinal canal cross-section area and lateral recesses cross-sectional area were valuable. Coefficient of stenosis was calculated for the case and control groups which had statistically significant difference (p<0.001). The difference between qualitative findings such as disc protrusion, extrusion, sequestration and Cauda Equine serpain or redundant was significant between the two groups.Conclusion:According to the results, among the quantitative criteria of MRI imaging findings, central spinal canal cross-section (less than 77.5 mm2 for central stenosis) and lateral recesses cross-section (less than 22.5 mm2 for lateral stenosis) had the highest sensitivity and specificity for LSS diagnosis in symptomatic and asymptomatic patients with suspected LSS. Strongest observed correlation was between neurogenic claudication and LSS diagnostic radiological markers.