Assessment of Spinal Canal Diameters for Clinically Suspected Cases of Lumbar Canal Stenosis on MRI
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 1
Abstract
Background: Lumbar canal stenosis means reduced space available for the neural and vascular elements in the lumbar spine leading to low backache or lower extremity pain. Magnetic resonance imaging (MRI) is the key non-invasive test for assessment of lumbar canal stenosis. Studies have been performed to develop the criteria for spinal stenosis in the lumbar spine. However, till date no consensus on quantitative criteria has been made. Imaging with MRI, in our study, can help in formulating a cause and critical quantitative criteria for stenosis that can provide evidence-based recommendations for proper evaluation needed for optimum treatment of clinically suspected patients. Materials and methods: A total of 100 symptomatic cases who were suspected of lumbar canal stenosis, aged between 30 to 60 years, and 30 age matched asymptomatic controls underwent MRI of the lumbar spine. Patients were assessed for stenosis on the basis of six qualitative criteria, as given after the result of a Delphi survey in 2012. Various quantitative parameters were then measured at five levels (L1 to L5) and compared with the controls. Results: The narrowest mid sagittal anteroposterior spinal canal diameter at body (mean 13.9 mm) and at disc (mean 12.2 mm) level were seen at L4 level and L5-S1 level respectively while narrowest thecal sac diameters at body (mean 11.2 mm) and at disc (mean 8.9 mm) levels were seen at L5 level and L4-L5 level respectively. The cut off limits for spinal canal stenosis were given for spinal canal diameter at body, thecal sac diameter at body, spinal canal diameter at disc and thecal sac diameter at disc as 13.5 cm, 10.5 cm, 13.5 cm and 7.5 cm respectively. Conclusion: It was concluded that the thecal sac diameter at disc level with a critical value of 7.5 mm had highest sensitivity (87%) and specificity (84%) as far as canal stenosis was concerned and should be given highest priority while taking the measurements.
Authors and Affiliations
Dr. Pawan Soni, Dr. Dinesh Sood, Dr. Ira Jamwal, Dr. Rajeev Kapila
Keywords
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- EP ID EP431031
- DOI 10.9790/0853-1801037885.
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