Journal article
Relationship between sedimentation sign and morphological grade in symptomatic lumbar spinal stenosis.
- Laudato PA Department of Orthopedics, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Avenue Pierre-Decker 4, Lausanne, Switzerland.
- Kulik G Department of Orthopedics, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Avenue Pierre-Decker 4, Lausanne, Switzerland.
- Schizas C Neuro-Orthopaedic Spine Unit, Hirslanden Group of Private Hospitals, Clinique Cecil, Lausanne, Switzerland. cschizas@hotmail.com.
- 2015-05-20
Published in:
- European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society. - 2015
Classification
Imaging studies
Lumbar spinal stenosis
Morphological stenosis grade
Sedimentation sign
Humans
Lumbar Vertebrae
Magnetic Resonance Imaging
Prospective Studies
Spinal Stenosis
English
PURPOSE
We aimed to study the relationship between two morphological parameters recently described on MRI images in relation to lumbar spinal stenosis (LSS): the first is the sedimentation sign (SedS) and the second is the morphological grading of lumbar stenosis.
MATERIALS AND METHODS
MRIs from a total of 137 patients were studied. From those, 110 were issued from a prospective database of symptomatic LSS patients, of whom 73 were treated surgically and 37 conservatively based on symptom severity. A third group consisting of 27 subjects complaining of low back pain (LBP) served as control. Severity of stenosis was judged at disc level using the four A to D grade morphological classification. The presence of a SedS was judged at pedicle level, above or below the site of maximal stenosis.
RESULTS
A positive SedS was observed in 58, 69 and 76% of patients demonstrating B, C and D morphology, respectively, but in none with grade A morphology. The SedS was positive in 67 and 35% of the surgically and conservatively treated patients, respectively, and in 8% of the LBP group. C and D morphological grades were present in 97 and 35% of patients in the surgically and conservatively treated group, respectively, and in 18% of the LBP group. Presence of a positive SedS carried an increased risk of being submitted to surgery in the symptomatic LSS group (OR 3.5). This risk was even higher in the LSS patients demonstrating grade C or D morphology (OR 65).
DISCUSSION AND CONCLUSION
One-third of surgically treated LSS patients do not present a SedS. This sign appears to be a lesser predictor of treatment modality in our setting of symptomatic LSS patients compared to the severity of stenosis judged by the morphological grade.
We aimed to study the relationship between two morphological parameters recently described on MRI images in relation to lumbar spinal stenosis (LSS): the first is the sedimentation sign (SedS) and the second is the morphological grading of lumbar stenosis.
MATERIALS AND METHODS
MRIs from a total of 137 patients were studied. From those, 110 were issued from a prospective database of symptomatic LSS patients, of whom 73 were treated surgically and 37 conservatively based on symptom severity. A third group consisting of 27 subjects complaining of low back pain (LBP) served as control. Severity of stenosis was judged at disc level using the four A to D grade morphological classification. The presence of a SedS was judged at pedicle level, above or below the site of maximal stenosis.
RESULTS
A positive SedS was observed in 58, 69 and 76% of patients demonstrating B, C and D morphology, respectively, but in none with grade A morphology. The SedS was positive in 67 and 35% of the surgically and conservatively treated patients, respectively, and in 8% of the LBP group. C and D morphological grades were present in 97 and 35% of patients in the surgically and conservatively treated group, respectively, and in 18% of the LBP group. Presence of a positive SedS carried an increased risk of being submitted to surgery in the symptomatic LSS group (OR 3.5). This risk was even higher in the LSS patients demonstrating grade C or D morphology (OR 65).
DISCUSSION AND CONCLUSION
One-third of surgically treated LSS patients do not present a SedS. This sign appears to be a lesser predictor of treatment modality in our setting of symptomatic LSS patients compared to the severity of stenosis judged by the morphological grade.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1007/s00586-015-4021-z
- PMID 25987454
- Persistent URL
- https://sonar.ch/global/documents/20412
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