Clinical and MRI findings in lumbar spinal stenosis: baseline data from the NORDSTEN study

Jørn Aaen, Ivar Magne Austevoll, Christian Hellum, Kjersti Storheim, Tor Åge Myklebust, Hasan Banitalebi, Masoud Anvar, Jens Ivar Brox, Clemens Weber, Tore Solberg, Oliver Grundnes, Helena Brisby, Kari Indrekvam, Erland Hermansen

June 2022, Volume 31, Issue 6, pp 1391 - 1398 Original Article Read Full Article

First Online: 19 November 2021

Purpose

The aim was to describe magnetic resonance imaging findings in patients planned for lumbar spinal stenosis surgery. Further, to describe possible associations between MRI findings and patient characteristics with patient reported disability or pain.

Methods

The NORDSTEN spinal stenosis trial included 437 patients planned for surgical decompression of LSS. The following MRI findings were evaluated before surgery: morphological (Schizas) and quantitative (cross-sectional area) grade of stenosis, disk degeneration (Pfirrmann), facet joint tropism and fatty infiltration of the multifidus muscle. Patients were dichotomized into a moderate or severe category for each radiological parameter classification. A multivariable linear regression analysis was performed to investigate the association between MRI findings and preoperative scores for Oswestry Disability Index, Zurich Claudication Questionnaire and Numeric rating scale for back and leg pain. The following patient characteristics were included in the analysis: gender, age, smoking and weight.

Results

The percentage of patients with severe scores was as follows: Schizas (C + D) 71.3%, cross-sectional area (

Conclusion

In this cross-sectional study, the majority of the patients had MRI findings classified as severe LSS changes, but the findings had no clinically relevant association with patient reported disability and pain at baseline. Patient characteristics have a larger impact on disability and pain than radiological findings.

Trial registration

www.ClinicalTrials.gov identifier: NCT02007083, registered December 2013.

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