Abstract
BackgroundIn lumbar spinal stenosis (LSS), at most times, several levels are impaired and selecting the correct level remains a common problem for surgeons, as surgery remains invasive, and extended laminectomy may lead to secondary surgical complications. Therefore, helping to select the correct level may be useful for surgeons. The use of diffuse tensor imaging (DTI) and paraspinal mapping (PM) in addition to conventional magnetic resonance imaging (MRI) may be helpful (Chen et al., J Orthop Surg Res 11:47, 2016). However, with decompression levels determined by conventional magnetic resonance imaging (MRI) increasing, whether the benefits of reducing decompression level of conventional MRI + (DTI or PM) will be more obvious is unknown.MethodsReduced surgical levels that were different between levels determined by conventional MRI + (DTI or PM) and conventional MRI + neurogenic examination (NE) between groups were compared. Treatment outcome measures were performed at 2 weeks, 3 months, 6 months, and 12 months postoperatively.ResultsThe reduced levels of three groups showed no statistically significant differences between each other except for two levels and four levels (two levels/three levels, p = 0.085; two levels/four levels, p = 0.039; three levels/ four levels, p = 0.506, respectively).ConclusionsWith surgical levels determined by conventional MRI increasing, the benefits of DTI and PM will be uncertainly more obvious.
Highlights
The term lumbar spinal stenosis (LSS) is commonly used to describe patients with symptoms related to anatomical reduction in lumbar spinal canal
In patients who have no concordance between radiological and clinical symptoms, the surgical levels determined by conventional magnetic resonance imaging and neurogenic examination (NE) may lead to a more extensive surgery and secondary surgical complications
Enrollment and grouping Symptomatic patients of aged 40–90 years with degenerative lumbar spinal stenosis detected on conventional magnetic resonance imaging (MRI) or radiography from October 2015 to October 2017 were enrolled in this study
Summary
The term lumbar spinal stenosis (LSS) is commonly used to describe patients with symptoms related to anatomical reduction in lumbar spinal canal. The extent of narrowing of the spinal canal correlates poorly with symptom severity, and radiologically significant lumbar spinal stenosis is found in asymptomatic individuals [4,5,6,7]. In patients who have no concordance between radiological and clinical symptoms, the surgical levels determined by conventional magnetic resonance imaging (conventional MRI) and neurogenic examination (NE) may lead to a more extensive surgery and secondary surgical complications. In lumbar spinal stenosis (LSS), at most times, several levels are impaired and selecting the correct level remains a common problem for surgeons, as surgery remains invasive, and extended laminectomy may lead to secondary surgical complications. The use of diffuse tensor imaging (DTI) and paraspinal mapping (PM) in addition to conventional magnetic resonance imaging (MRI) may be helpful (Chen et al, J Orthop Surg Res 11:47, 2016). With decompression levels determined by conventional magnetic resonance imaging (MRI) increasing, whether the benefits of reducing decompression level of conventional MRI + (DTI or PM) will be more obvious is unknown
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