Reliability in Grading the Severity of Lumbar Spinal Stenosis

Drew, Raymond L; Bhandari, Mohit; Kulkarni, Arvind; Louw, D.J.; Reddy, Kalyan; Dunlop, Boadie W.

doi:10.1097/00002517-200006000-00010

Cited by 42 publications

(36 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 Lateral recess stenosis was not recorded for this analysis due to poor reliability in previous studies and a lack of consensus on optimal grading. 16 An inter-rater reliability study for extraction of imaging-detected LSS based on our definition was conducted in support of the methods (Kappa statistic = 0.87; 95% agreement).…”

Section: Methodsmentioning

confidence: 89%

Association of Neuromuscular Attributes With Performance-Based Mobility Among Community-Dwelling Older Adults With Symptomatic Lumbar Spinal Stenosis

Schmidt

Ward

Suri

et al. 2017

Archives of Physical Medicine and Rehabilitation

View full text Add to dashboard Cite

Objective To identify differences in health factors, neuromuscular attributes and performance-based mobility among community-dwelling older adults with symptomatic lumbar spinal stenosis (SLSS); and to determine which neuromuscular attributes are associated with performance-based measures of mobility. We hypothesized that: (1) community-dwelling older adults with SLSS would have poorer health, greater neuromuscular impairment and worse mobility; and (2) greater impairment in trunk extensor muscle endurance, leg strength, leg speed and knee flexion range of motion (ROM) would be associated with performance-based mobility. Design Cross-sectional; secondary data analysis of a cohort study Setting outpatient rehabilitation center Participants Community-dwelling adults ≥ 65 years with self-reported mobility limitations and SLSS Interventions N/A Main Outcome Measures Short Physical Performance Battery Score, Habitual Gait Speed, and Chair Stand Test Results SLSS was classified using self-reported symptoms of neurogenic claudication and imaging. Among 430 community-dwelling older adults 54(13%) met criteria for SLSS. Compared to participants without SLSS, those with SLSS had more comorbidities, higher BMI, greater pain and less balance confidence. Participants with SLSS had greater impairment in trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion range of motion (ROM), knee extension ROM, and ankle ROM compared to participants without SLSS. Five neuromuscular attributes were associated with performance-based mobility among participants with SLSS: trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry. Conclusions Community-dwelling older adults with self-reported mobility limitations with SLSS exhibit poorer health characteristics, greater neuromuscular impairment and worse mobility when compared to those without SLSS. Poorer trunk extensor muscle endurance, leg strength, leg strength asymmetry, knee flexion ROM, and knee extension ROM asymmetry were associated with performance-based mobility among participants with SLSS.

show abstract

Section: Methodsmentioning

confidence: 89%

Association of Neuromuscular Attributes With Performance-Based Mobility Among Community-Dwelling Older Adults With Symptomatic Lumbar Spinal Stenosis

Schmidt

Ward

Suri

et al. 2017

Archives of Physical Medicine and Rehabilitation

View full text Add to dashboard Cite

show abstract

“…In the single-level group, the preoperative JOA scores averaged 13.3 points (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] There were also no major complications in this group. However, one patient had a postoperative recurrence of the symptoms within 5 months and required additional posterior decompression at the same spinal level.…”

Section: Resultsmentioning

confidence: 99%

“…In the current series, 73 of 150 patients (49 %) were diagnosed as multiple-level involvements, and sufficient clinical results were obtained after surgery. Imaging features of the spinal involvement, facet joint arthrosis, ligament flavum hypertrophy, disc protrusion, and nerve root impingement should be assessed for exact diagnosis, and MRI and CT have been used for the clinical assessment of LSS [18,19]. Sato and Kikuchi reported the clinical analysis of two spinal level compression in LSS patients [15].…”

Section: Discussionmentioning

confidence: 99%

Clinical results of microsurgical bilateral decompression via unilateral approach for lumbar canal stenosis with multiple-level involvement

Tanaka

Nakanishi

Kamei

et al. 2014

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

show abstract

“…Because of the large interobserver variability in diagnosing root compression and lumbar spinal canal stenosis using MRI, it is recommended that MRI findings alone should not be used when assessment is required for a surgical decision; in these cases, a higher-Tesla MRI would be a better alternative [21]. A score developed by Azimi et al [22] is also generally considered reliable and valid, and it can be used in the decision-making process with respect to surgical intervention.…”

Section: Discussionmentioning

confidence: 99%

Using Magnetic Resonance Myelography to Improve Interobserver Agreement in the Evaluation of Lumbar Spinal Canal Stenosis and Root Compression

Al-Tameemi

Al-Essawi²,

Shukri

et al. 2017

Asian Spine J

View full text Add to dashboard Cite

Study DesignCross-sectional retrospective study designed to assess interobserver agreement.PurposeTo investigate if interobserver agreement using magnetic resonance imaging (MRI) in the evaluation of lumbar spinal canal stenosis and root compression can be improved upon combination with magnetic resonance myelography (MRM).Overview of LiteratureThe interpretation of lumbar spinal MRI, which is the imaging modality of choice, often has a significant influence on the diagnosis and treatment of low back pain. However, using MRI alone, substantial interobserver variability has been reported in the evaluation of lumbar spinal canal stenosis and nerve root compression.MethodsHardcopies of 30 lumbar spinal MRI (containing a total of 150 disk levels) as well as MRM films were separately reviewed by two radiologists and a neurosurgeon. At each intervertebral disk, the observers were asked to evaluate the thecal sac for the presence and degree of spinal stenoses (mild, moderate, or severe) and presence of root canal compression. Interobserver agreement was measured using weighted kappa statistics.ResultsRegarding lumbar spinal canal stenosis, interobserver agreement between the two radiologists was moderate (kappa, 0.4) for MRI and good (kappa, 0.6) for combination with MRM. However, the agreement between the radiologist and neurosurgeon remained fair for MRI alone or in combination with MRM (kappa, 0.38 and 033, respectively). In the evaluation of nerve root compression, interobserver agreement between the radiologists improved from moderate (kappa, 0.57) for MRI to good (kappa, 0.73) after combination with MRM; moderate agreement between the radiologist and neurosurgeon was noted for both MRI alone and after combination with MRM (kappa, 0.58 and 0.56, respectively).ConclusionsInterobserver agreement in the evaluation of lumbar spinal canal stenosis and root compression between the radiologists improved when MRM was combined with MRI, relative to MRI alone.

show abstract

Reliability in Grading the Severity of Lumbar Spinal Stenosis

Cited by 42 publications

References 19 publications

Association of Neuromuscular Attributes With Performance-Based Mobility Among Community-Dwelling Older Adults With Symptomatic Lumbar Spinal Stenosis

Association of Neuromuscular Attributes With Performance-Based Mobility Among Community-Dwelling Older Adults With Symptomatic Lumbar Spinal Stenosis

Clinical results of microsurgical bilateral decompression via unilateral approach for lumbar canal stenosis with multiple-level involvement

Using Magnetic Resonance Myelography to Improve Interobserver Agreement in the Evaluation of Lumbar Spinal Canal Stenosis and Root Compression

Contact Info

Product

Resources

About