title: Magnetic resonance imaging predictors of surgical outcome in degenerative lumbar spinal stenosis.
abstract: OBJECTIVE
  To identify any MRI predictors for surgical outcomes of patients with degenerative lumbar spinal stenosis (DLSS) having instrumented posterior decompression (IPD) surgery.
  
  
  METHODS
  Seventy patients with DLSS who underwent IPD were reviewed retrospectively. The clinical score of each patient was assessed using the JOAS (Japanese Orthopedics Association Scoring) system, which is mainly based on the subjective symptoms and physical signs of the patients before (JOAS-I) and after (JOAS-II) surgery. Healing rate (HR) was calculated as: [(JOAS-II) - (JOAS-I)] × 100/[15 - (JOAS-I)]. HR >50 % was considered clinical improvement. Radiological stenosis was assessed on MRI and was graded from 0 to 3 at the laminectomy level in terms of thecal sac-nerve root compression, foraminal stenosis, and facet degeneration.
  
  
  RESULTS
  Mean HR of the improved patients (n = 39) was 81.94; HR of the unimproved patients (n = 31) was 34.75 (p < 0.05). There was no statistical difference in radiological stenosis parameters between the two groups (p > 0.05). HR was worse in patients with severe facet degeneration.
  
  
  CONCLUSIONS
  Surgical outcomes of DLSS depend on multiple variables. It is not possible to predict the outcomes by assessing only one parameter. The possible outcomes should be analyzed by considering all the factors individually.
authors.affiliation: Department of Radiology, Near East University Medical Faculty, Near East Boulevard, Mersin 10, Nicosia, North Cyprus, Turkey. alicioglu.b@gmail.com
authors.forename: Banu
authors.initials: B
authors.lastname: Alicioglu
authors.forename: Baris
authors.initials: B
authors.lastname: Yilmaz
authors.forename: Nail
authors.initials: N
authors.lastname: Bulakbasi
authors.forename: Cem
authors.initials: C
authors.lastname: Copuroglu
authors.forename: Erol
authors.initials: E
authors.lastname: Yalniz
authors.forename: Bilal
authors.initials: B
authors.lastname: Aykac
authors.forename: Devrim Ulas
authors.initials: DU
authors.lastname: Urut
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000473:pathology* / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011237:Predictive Value of Tests; D057234:Preoperative Period; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013130:Spinal Stenosis / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome