Magnetic Resonance Imaging Quantification of Lumbar Spinal Canal Stenosis in Symptomatic Subjects

• Main Authors: Siddarth Ragupathi, Ajit Kumar Reddy, Jayaraman Gopal
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2017-10-01
• Series: International Journal of Anatomy Radiology and Surgery
• Subjects: Cauda equina; Intervertebral discs; Low backache; Neural foramina; Oswestry Disability Index (ODI)
• Online Access: http://www.ijars.net/articles/PDF/2322/29056_CE[VSU]_F(GH)_PF1(VSU_GG)_PFA(VSU_GG)_PF2(VSU_GG).pdf

Introduction: Low backache is a common condition to occur in the middle age. It is mainly caused by the degeneration of the intervertebral disc which forms the main support to the vertebral column. Lumbar spinal canal stenosis results in the compression of spinal cord and nerves at the level of lumbar vertebra. Aim: The purpose of this study is to measure the spinal canal dimensions and correlate with the clinical symptoms to establish a radiological criterion based on MRI for diagnosis of lumbar canal stenosis. This study is done to improve the diagnostic accuracy of lumbar spinal canal stenosis. Materials and Methods: Two hundred subjects with complaints of low backache without a traumatic history underwent Magnetic Resonance Imaging (MRI) after assessment of pain by two methods: 1. Oswestry Disability Index (ODI) scoring and 2. Wong Baker Facial Expression scale. All the images were qualitatively analyzed to obtain the MRI grading for central canal at various levels from L1 to S1 vertebra after making sure that the neural foramina is not involved. Anteroposterior (AP) and transverse diameter of spinal canal at intervertebral disc and upper part of vertebral body levels and spinal canal area are measurements that are taken. Descriptive and inferential statistical analysis has been carried out in the present study. Results on continuous measurements are presented on mean±SD (min-max) and results on categorical measurements are presented in number (%). Significance is assessed at 5% level of significance. Results: The spinal canal diameter measured along its AP and transverse direction is found to be correlating with the severity of low backache complained by the patient. Comparing the two methods of clinical assessment, ODI scoring was found to be more significant. Conclusion: The spinal canal measurements can be used as a radiologic criterion for diagnosis of acquired lumbar spinal canal stenosis. This will improve the diagnostic accuracy. However, in case of presence of any other pathology or traumatic history with bony fractures, these criterions could not be used.