Interdisciplinary Neurosurgery (Sep 2022)
Study on the correlation between radiological indicators, seven-grade classification and Oswestry disability index of surgical spinal stenosis
Abstract
Objective: The seven-grade classification refers to a morphological grade of lumbar spinal stenosis (LSS), while the postoperative ODI improvement rate in patients with different grade is still unclear. We explored the potential significance of morphological grade in treatment decision making. In addition, we also conducted a relevant assessment of radiological indicators and symptom indexes. Methods: A retrospective cohort study performed decompression surgery in 156 LSS patients with claudication. According to the morphological grade, namely A3 (n = 29), A4 (n = 30), B (n = 33), C (n = 36) and D (n = 28), the patients were divided into 5 groups. Two radiological indicators included the largest cross-sectional area difference (CSAD) of the dural sac and the min AP/max AP, and symptom indexes included an Oswestry disability index (ODI). Results: The relevance between the radiological indicators and the symptom indexes was analyzed. In Pearson analysis, min AP/max AP and preoperative ODI, postoperative ODI, and postoperative ODI improvement rate were r = −0.384 (p < 0.05), r = −0.463 (p < 0.05), and r = −0.461 (p < 0.05), respectively. In Spearman analysis, the CSAD was only statistically significant with postoperative ODI, and the correlation coefficient was ρ = 0.288 (p < 0.05). On LSD-t test, the differences in preoperative ODI between C and A3, A4 (p < 0.05), D and A3, A4, B (p < 0.05) were statistically significant. In terms of postoperative ODI improvement rate, A3 and A4 were significantly different from C and D (p < 0.05). Conclusions: The min AP/max AP has a better predictability for patients’ symptom indexes, and the seven-grade classification has good guidance in the choice of treating patients with LSS.
