Clinical correlation of radiological spinal stenosis after standardization for vertebral body size.
OBJECTIVE
To determine the relationship between the degree of radiographic lumbar spinal stenosis, adjusted with an internal control for vertebral body size, and disability from lumbar stenosis.


METHODS
one hundred and twenty-three consecutive patients with clinical and radiological confirmation of neural impingement secondary to lumbar stenosis were enrolled prospectively. Thecal sac anteroposterior (AP) diameter (TSD) and cross-sectional area (CSA), and vertebral body AP dimension (VBD) were determined. These parameters were then correlated with patients' symptoms using the modified Roland-Morris questionnaire (RMQ) disability score.


RESULTS
No statistically significant inverse correlation was found between the TSD and RMQ score (p=0.433), between the CSA and RMQ score (p=0.124), or between the TSD:VBD ratio and RMQ score (p=0.109). There was a significant positive correlation between the CSA:VBD ratio and RMQ score (p=.036), and therefore, there was no statistical support for an inverse relationship between the two. There was a significant difference in mean RMQ scores when the patients were divided into those with CSA greater than or equal to 70 mm(2) and those less than 70 mm(2), with T=-2.104 and p=0.038.


CONCLUSIONS
The degree of radiographic lumbar spinal stenosis, even with the use of an internal control of vertebral body size and standardized disability questionnaires, does not correlate with clinical symptoms. However, patients with more severe stenosis below a CSA critical threshold of 70 mm(2), have significantly greater functional disability.
Athiviraham
A
A
Department of Surgery, Division of Orthopaedic Surgery, Queen's University, Kingston, Ontario, Canada.
Yen
D
D
Scott
C
C
Soboleski
D
D
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000473:pathology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011859:Radiography; D013115:Spinal Canal; D013130:Spinal Stenosis / Q000000981:diagnostic imaging*