Criteria for selection of patients with lumbar intervertebral disc herniation complicated by spinal canal stenosis
DOI:
https://doi.org/10.14739/2310-1210.2021.6.234528Keywords:
intervertebral disc herniation, spinal stenosis, clinical and instrumental correlation, spinal canalAbstract
Aim – to evaluate clinical and instrumental correlation (MRI data) in patients with lumbar intervertebral disc herniation complicated by spinal canal stenosis for optimizing the indications for differentiated surgical treatment.
Materials and methods. Clinical and neurological manifestations and MRI data in 80 patients (men – 36, women – 44), aged 27 to 72 years with a diagnosis of intervertebral disc herniation complicated by spinal canal stenosis were retrospectively analyzed. Depending on the size of the spinal canal, there were 2 groups: the first – with relative spinal canal stenosis (n = 20) – 75–100 mm2, and the second group – with absolute spinal canal stenosis (n = 60) – less than 75 mm2. We examined the correlation between the clinical and neurological presentations and MRI findings.
Results. Our retrospective analysis has found that the first group consisted mainly of younger patients (46 years) and with a mean intervertebral disc herniation of 8.35 mm, while the second group included older patients (51.7 years) and the mean size of intervertebral disc herniation was 7.3 mm. The group of relative spinal canal stenosis was dominated by patients with radiculopathy syndrome (70 %) and pain in one lower limb (85 %). Radiculoischemia syndrome (50 %), pain in both lower extremities (33 %), neurogenic intermittent claudication syndrome (46.6 %), knee reflex disorders (58.3 %), pelvic organ dysfunction (11.6 %) were more common in the second group of patients. In addition, the longest disease duration (more than 24 months) was observed among patients of this group. We have found a relationship between pain syndrome (according to VAS), muscle strength, the disease duration and the spinal canal area.
Conclusions. The correlation of clinical and instrumental methods of examination in patients with intervertebral disc herniation complicated by spinal canal stenosis allows the indications for differentiated surgery to be optimized.
References
Baber, Z., & Erdek, M. A. (2016). Failed back surgery syndrome: current perspectives. Journal of Pain Research, 9, 979-987. https://doi.org/10.2147/JPR.S92776
Campbell, P., Wynne-Jones, G., Muller, S., & Dunn, K. M. (2013). The influence of employment social support for risk and prognosis in nonspecific back pain: a systematic review and critical synthesis. International Archives of Occupational and Environmental Health, 86(2), 119-137. https://doi.org/10.1007/s00420-012-0804-2
Cowley, P. (2016). Neuroimaging of Spinal Canal Stenosis. Magnetic Resonance Imaging Clinics of North America, 24(3), 523-539. https://doi.org/10.1016/j.mric.2016.04.009
Hartman, J., Granville, M., & Jacobson, R. E. (2019). Radiologic Evaluation Of Lumbar Spinal Stenosis: The Integration Of Sagittal And Axial Views In Decision Making For Minimally Invasive Surgical Procedures. Cureus, 11(3), Article e4268. https://doi.org/10.7759/cureus.4268
Hennemann, S., & de Abreu, M. R. (2021). Degenerative Lumbar Spinal Stenosis. Revista Brasileira de Ortopedia, 56(1), 9-17. https://doi.org/10.1055/s-0040-1712490
Hughes, A., Makirov, S. K., & Osadchiy, V. (2015). Measuring spinal canal size in lumbar spinal stenosis: description of method and preliminary results. International Journal of Spine Surgery, 9, Article 8. https://doi.org/10.14444/2008
Kreiner, D. S., Shaffer, W. O., Baisden, J. L., Gilbert, T. J., Summers, J. T., Toton, J. F., Hwang, S. W., Mendel, R. C., Reitman, C. A., & North American Spine Society. (2013). An evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spinal stenosis (update). The Spine Journal, 13(7), 734-743. https://doi.org/10.1016/j.spinee.2012.11.059
Lafian, A. M., & Torralba, K. D. (2018). Lumbar Spinal Stenosis in Older Adults. Rheumatic Diseases Clinics of North America, 44(3), 501-512. https://doi.org/10.1016/j.rdc.2018.03.008
Lee, S. Y., Kim, T. H., Oh, J. K., Lee, S. J., & Park, M. S. (2015). Lumbar Stenosis: A Recent Update by Review of Literature. Asian Spine Journal, 9(5), 818-828. https://doi.org/10.4184/asj.2015.9.5.818
Majidi, H., Shafizad, M., Niksolat, F., Mahmudi, M., Ehteshami, S., Poorali, M., & Mardanshahi, Z. (2019). Relationship Between Magnetic Resonance Imaging Findings and Clinical Symptoms in Patients with Suspected Lumbar Spinal Canal Stenosis: a Case-control Study. Acta Informatica Medica, 27(4), 229-233. https://doi.org/10.5455/aim.2019.27.229-233
Nordberg, C. L., Boesen, M., Fournier, G. L., Bliddal, H., Hansen, P., & Hansen, B. B. (2021). Positional changes in lumbar disc herniation during standing or lumbar extension: a cross-sectional weight-bearing MRI study. European Radiology, 31(2), 804-812. https://doi.org/10.1007/s00330-020-07132-w
O’Dell, M. C., Kohler, N. J., Harshman, B. K., Messina, S. A., Wasyliw, C. W., Felsberg, G., & Bancroft, L. W. (2016). Degenerative Disease of the Spine and Other Spondyloarthropathies. In L. Saba (Ed.), Imaging of the Pelvis, Musculoskeletal System, and Special Applications to CAD (pp. 179-203). CRC Press. https://doi.org/10.1201/b19531-9
Steurer, J., Roner, S., Gnannt, R., & Hodler, J. (2011). Quantitative radiologic criteria for the diagnosis of lumbar spinal stenosis: a systematic literature review. BMC Musculoskeletal Disorders, 12, Article 175. https://doi.org/10.1186/1471-2474-12-175
Tong, Y., Huang, Z., Hu, C., Fan, Z., Bian, F., Yang, F., & Zhao, C. (2020). A comparison study of posterior cervical percutaneous endoscopic ventral bony decompression and simple dorsal decompression treatment in cervical spondylotic radiculopathy caused by cervical foraminal and/or lateral spinal stenosis: a clinical retrospective study. BMC Musculoskeletal Disorders, 21, Article 290. https://doi.org/10.1186/s12891-020-03313-2
Weigel, R., Capelle, H. H., Al-Afif, S., & Krauss, J. K. (2021). The dimensions of «failed back surgery syndrome»: what is behind a label? Acta Neurochirurgica, 163(1), 245-250. https://doi.org/10.1007/s00701-020-04548-7
Zhou, Z., Jin, Z., Zhang, P., Shan, B., Zhou, Z., Zhang, Y., Deng, Y., & Zhou, X. (2020). Correlation Between Dural Sac Size in Dynamic Magnetic Resonance Imaging and Clinical Symptoms in Patients with Lumbar Spinal Stenosis. World Neurosurgery, 134, e866-e873. https://doi.org/10.1016/j.wneu.2019.11.011
Zileli, M., Crostelli, M., Grimaldi, M., Mazza, O., Anania, C., Fornari, M., & Costa, F. (2020). Natural Course and Diagnosis of Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations. World Neurosurgery: X, 7, Article 100073. https://doi.org/10.1016/j.wnsx.2020.100073
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
