Comparison of quantitative and qualitative magnetic resonance imaging parameters with each other and clinical findings for diagnosis and staging of lumbar spinal stenosis.
2nd International Medical Congress of Izmir Democracy University, İzmir, Türkiye, 17 - 20 Aralık 2020, ss.502-510, (Tam Metin Bildiri)
- Yayın Türü: Bildiri / Tam Metin Bildiri
- Basıldığı Şehir: İzmir
- Basıldığı Ülke: Türkiye
- Sayfa Sayıları: ss.502-510
- Maltepe Üniversitesi Adresli: Hayır
Özet
AIM: In this study, the aim was to compare “qualitative” and “quantitative” magnetic resonance imaging (MRI) parameters used for radiological diagnosis of lumbar spinal stenosis (LSS) with each other, to identify the use of these parameters when staging the disease and the correlation of these parameters with “clinical symptoms and findings”. MATERIAL-METHOD: Our study included 75 patients attending the Physical Medicine and Rehabilitation clinic with clinical diagnosis of lumbar spinal stenosis and lumbar MRI performed in the radiology clinic. MRI parameters like “quantitative measurements” of radiological spinal canal and dural sheath anterior-posterior diameters, and cross-sectional areas of the “dural sheath” and “spinal canal”, and “qualitative staging” (examining the compression ratio of the dural sheath), stenosis rates and lateral recess diameter were measured at levels where stenosis was maximum. The correlations between these parameters with clinical symptoms used for diagnosis and staging of “functional disability” (Oswestry Disability Index or Oswestry Pain score) and “neurological LSS findings” (neuropathic pain or neurogenic claudication causing this) were assessed. RESULTS: When the radiological measurement parameters obtained from MRI to assess the lumbar spinal canal are compared, the strongest correlation for staging was observed between the “dural sheath area measurement” on axial sections with the “dural sheath anterior-posterior diameter measurements” (P:0.02). When the area and diameter measurements on MRI are compared with qualitative staging, the highest rate of correlation between staging systems was observed for the “dural sheath area measurement” (P:0.01). When the radiological measurement parameters are compared with functional disability scores, the highest level of correlation with the “Oswestry Disability Index” was identified for “dural sheath anterior-posterior diameter measurements on axial sections” (P:0.02). Another clinical marker and clinical finding accepted as causing morbidity in spinal stenosis of “neurogenic claudication distance” (NCD) had statistical correlation with “qualitative staging” used most frequently and practically among imaging parameters (P:0.03), which was much lower than the correlation between NCD with “spinal canal area measurement” on axial sections (P:0.005). CONCLUSION: In our study of LSS, it was identified that NCD and “Oswestry Disability Index” used especially as clinical markers for disease staging overlapped with statistically different radiological measurement parameters (diameter and area on MRI). Clinically, the most determinant method for disease staging of NCD was identified to have the best correlation