|
KMID : 1001920170600040465
|
|
Journal of Korean Neurosurgical Society
2017 Volume.60 No. 4 p.465 ~ p.470
|
|
|
Correlation between MRI Grading System and Surgical Findings for Lumbar Foraminal Stenosis
|
|
Jeong Tae-Seok
Ahn Yong
Lee Sang-Gu
Kim Woo-Kyung
Son Seong
Kwon Jung-Hwa
|
|
|
Abstract
|
|
|
Objective: Magnetic resonance imaging (MRI) grading systems using sagittal images are useful for evaluation of lumbar foraminal stenosis. We evaluated whether such a grading system is useful as a diagnostic tool for surgery.
Methods: Between July 2014 and June 2015, 99 consecutive patients underwent unilateral lumbar foraminotomy for lumbar foraminal stenosis. Surgically confirmed foraminal stenosis and the contralateral, asymptomatic neuroforamen were assessed based on a 4-point MRI grading system. Two experienced researchers independently evaluated the MR sagittal images. Interobserver agreement and intraobserver agreement were analyzed using κ statistics.
Results: The mean age of patients (54 women, 45 men) was 62.5 years. A total of 101 levels (202 neuroforamens) were evaluated. MRI grades for operated neuroforamens were as follows: Grade 0 in 0.99%, Grade 1 in 5.28%, Grade 2 in 14.85%, and Grade 3 in 78.88%. Interobserver agreement was moderate for operated neuroforamens (κ=0.511) and good for asymptomatic neuroforamens (κ=0.696). Intraobserver agreement by reader 1 for operated neuroforamens was good (κ=0.776) and that for asymptomatic neuroforamens was very good (κ=0.831). In terms of lumbar level, interobserver agreement for L5-S1 (κ=0.313, fair) was relatively lower than the other level (κ=0.804, very good).
Conclusion: MRI grading system for lumbar foraminal stenosis is thought to be useful as a diagnostic tool for surgery in the lumbar spine; however, it is less reliable for symptomatic L5-S1 foraminal stenosis than for other levels. Thus, various clinical factors as well as the MRI grading system are required for surgical decision-making.
|
|
|
KEYWORD
|
|
|
Spinal stenosis , Lumbar vertebrae , Magnetic resonance imaging , Foraminotomy , Surgery
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
   
|
|