A novel MRI classification system for congenital functional lumbar spinal stenosis predicts the risk for tandem cervical spinal stenosis.
The purpose of this study was to develop a simple and clinically useful morphological classification system for congenital lumbar spinal stenosis using sagittal MRI, allowing clinicians to recognize patterns of lumbar congenital stenosis quickly and be able to screen these patients for tandem cervical stenosis.



Forty-four subjects with an MRI of both the cervical and lumbar spine were included. On the lumbar spine MRI, the sagittal canal morphology was classified as one of three types: Type I normal, Type II partially narrow, Type III globally narrow. For the cervical spine, the Torg-Pavlov ratio on X-ray and the cervical spinal canal width on MRI were measured. Kruskal-Wallis analysis was done to determine if there was a relationship between the sagittal morphology of the lumbar spinal canal and the presence of cervical spinal stenosis.



Subjects with a type III globally narrow lumbar spinal canal had a significantly lower cervical Torg-Pavlov ratio and smaller cervical spinal canal width than those with a type I normal lumbar spinal canal.



A type III lumbar spinal canal is a globally narrow canal characterized by a lack of spinal fluid around the conus. This was defined as "functional lumbar spinal stenosis" and is associated with an increased incidence of tandem cervical spinal stenosis.
Department of Orthopaedic Surgery, University of Pittsburgh, Kaufman Building Suite 1011, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA. vaneckcf@upmc.edu.
Carola F
CF
van Eck
Department of Orthopaedic Surgery, University of Pittsburgh, Kaufman Building Suite 1011, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA.
Nicholas T
NT
Spina Iii
Department of Orthopaedic Surgery, University of Pittsburgh, Kaufman Building Suite 1011, 3471 Fifth Avenue, Pittsburgh, PA, 15213, USA.
Joon Y
JY
Lee
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D013130:Spinal Stenosis / Q000145:classification* / Q000151:congenital / Q000000981:diagnostic imaging*
Cervical spinal stenosis; Lumbar spinal stenosis; Spinal canal morphology; Tandem stenosis; Torg-Pavlov ratio