Natural Course and Diagnosis of Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations

Zılelı, Mehmet; Crostelli, Marco; Grimaldi, Marco; Mazza, Oscar; Anania, Carla Daniela; Fornari, Maurizio; Costa, Francesco

doi:10.1016/j.wnsx.2020.100073

Cited by 15 publications

(9 citation statements)

References 36 publications

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“…Lower back pain is affected by various factors, and has a broad spectrum of symptoms that requires differential diagnosis based on degenerative, congenital, and traumatic causes [ 25 ]. Escobar et al reported the preoperative absence of lower back pain in TKA as a predictor of a good quality of life in a multi-center prospective study conducted in 2007 [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Preoperative Total Knee Arthroplasty on Radiological and Clinical Outcomes of Spinal Fusion for Concurrent Knee Osteoarthritis and Degenerative Lumbar Spinal Diseases

Kim

Yang

Chang

et al. 2021

JCM

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Concurrent knee osteoarthritis (KOA) and degenerative lumbar spinal disease (LSD) has increased, but the total knee arthroplasty (TKA) effect on degenerative LSD remains unclear. The aim of this study was to retrospectively analyze to compare radiological and clinical outcomes between spinal fusion only and preoperative TKA with spinal fusion for the patients with concurrent KOA and degenerative LSD. A total of 72 patients with concurrent KOA and degenerative LSDs who underwent spinal fusion at less than three levels were divided in two groups: non-TKA group (n = 50) and preoperative TKA group (n = 22). Preoperative lumbar lordosis (LL) was significantly lower in the preoperative TKA group than the non-TKA group (p < 0.05). Significantly higher preoperative pelvic incidence (PI), PI/LL mismatch, and pelvic tilt (PT) occurred in preoperative TKA group than non-TKA group (all p < 0.05). There was significant improvement of postoperative Oswestry Disability Index and leg Visual Analog Scale in the preoperative TKA group (all p < 0.01). Preoperative TKA could be a benefit for in proper correction of sagittal spinopelvic alignment by spinal fusion. Therefore, preoperative TKA could be considered a preceding surgical option for patients with severe sagittal spinopelvic parameters in concurrent KOA and degenerative LSD.

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Section: Discussionmentioning

confidence: 99%

Impact of Preoperative Total Knee Arthroplasty on Radiological and Clinical Outcomes of Spinal Fusion for Concurrent Knee Osteoarthritis and Degenerative Lumbar Spinal Diseases

Kim

Yang

Chang

et al. 2021

JCM

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“…Сейчас уже сложно переоценить роль современных высокотехнологичных методов обследования, таких как компьютерная томография и особенно магнитно-резонансная томография (МРТ), в диагностике изменений позвоночника [1,2]. МРТ позволяет оценить степень и характер дегенеративных изменений межпозвонковых дисков (МПД), проследить субарахноидальные пространства, структурные изменения спинного мозга, корешков, а также выявить стеноз позвоночного канала с чувствительностью от 81 до 97 % [3,4].…”

Section: резюмеunclassified

“…Распространённость поясничного стеноза составляет 9 % среди населения в целом и до 47 % среди лиц старше 60 лет [14]. Чаще поясничный стеноз встречается у женщин [2]. Помимо приведённых дегенеративных изменений, стенозу способствуют врождённые (короткие дужки позвонковосновной причиной является ахондроплазия) и приобретённые (эпидуральный липоматоз) конституциональные изменения [4].…”

Section: материалы и методыunclassified

The current state of radiodiagnostics of degenerative changes in the lumbar spine (literature review)

Malakhanov

Селиверстов

Medvednikova

et al. 2022

Acta biomedica scientifica

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Examination of the spine using radiological methods remains the most frequently conducted study in the outpatient practice of almost any radiologist. In most cases, changes in the spine are degenerative and dystrophic in nature. These changes in the spine are the leading cause of loss of activity among adults and the elderly, and cover a wide range of age-related structural changes. It is of great importance to understand the possibilities and limitations of radiological methods of diagnostics. The description of morphological changes observed in degenerative and dystrophic changes requires the use of unified terminology and classifications among clinicians and radiologists.The aim. To present modern concepts in the assessment of degenerative changes of the spine using radiological methods. A description of the standardized international nomenclature of intervertebral disc pathology and current classifications of spinal canal stenosis are presented.Material and methods. For literature search, we used electronic databases MEDLINE (PubMed), eLibrary, EMBASE and Cochrane Library with a selection of sources published from 2000 to 2021. We analyzed the works devoted to the diagnosis of degenerative changes in lumbar spine and to degenerative stenosis.Conclusion. The key to productive communication between physicians is the uniformity or standardization of terminology and definitions used. It is important that the protocol of description, its terms, semantic expressions be uniform and understandable to specialists who are involved in the diagnosis and treatment of the spine. Magnetic resonance imaging is a valuable method in the diagnosis of degenerative changes of the spinal column, but it has its limitations.

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“…LSS is commonly associated with aging and progressive degenerative processes of the spine [ 2 ]. Patients often develop symptoms such as intermittent claudication, low back pain, and leg pain and/or weakness [ 3 , 4 ]. The results of a long-term follow-up study showed that only a portion of patients had aggravated symptoms, and the underlying mechanism was unclear [ 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Correlation of psoas major muscle morphology with function and clinical symptoms in patients with symptomatic multilevel lumbar spinal stenosis

Huang

Kong

et al. 2023

J Orthop Surg Res

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Objective This study was performed to quantify the morphological characteristics of the psoas major muscle in patients with symptomatic multilevel degenerative lumbar spinal stenosis (SMLSS) and assess the correlations of these morphological characteristics with function and clinical symptoms. Methods One hundred fourteen patients diagnosed with SMLSS (≥ 3 segments) were included. The patients’ presenting symptoms were assessed with the Oswestry Disability Index (ODI), and visual analogue scale (VAS) scores were recorded. The morphology of the psoas major was evaluated at the L3/4 intervertebral disc level in three ways: by measuring (i) the psoas muscle mass index (PMI); (ii) the mean muscle attenuation (Hounsfield units, HU); and (iii) the morphologic change of the psoas major (mean ratios of the short axis to the long axis of the bilateral psoas major). Results Men had a higher PMI than women (p = 0.001). Patients with severe disability had a significantly lower PMI (p = 0.002) and muscle attenuation (p = 0.001). The PMI and muscle attenuation were significantly higher in the patients with no or mild back pain (both p < 0.001). In the univariable and multivariable analyses, a greater HU value was associated with a higher functional status as assessed by the ODI (p = 0.002), and a higher PMI was associated with less severe back pain as measured by the VAS score (p < 0.001). Conclusion This study showed that muscle attenuation of psoas major positively correlated with the functional status and PMI negatively correlated with low back pain severity in patients diagnosed with SMLSS. Future prospective studies are needed to evaluate whether improvement in such muscle parameters through physiotherapy programs can alleviate the clinical symptoms and improve the functional status of patients with SMLSS.

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Natural Course and Diagnosis of Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations

Cited by 15 publications

References 36 publications

Impact of Preoperative Total Knee Arthroplasty on Radiological and Clinical Outcomes of Spinal Fusion for Concurrent Knee Osteoarthritis and Degenerative Lumbar Spinal Diseases

Impact of Preoperative Total Knee Arthroplasty on Radiological and Clinical Outcomes of Spinal Fusion for Concurrent Knee Osteoarthritis and Degenerative Lumbar Spinal Diseases

The current state of radiodiagnostics of degenerative changes in the lumbar spine (literature review)

Correlation of psoas major muscle morphology with function and clinical symptoms in patients with symptomatic multilevel lumbar spinal stenosis

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