MRI findings in patients with neurogenic claudication suspected to have central lumbar spinal stenosis

ABSTRACT

Central lumbar spinal stenosis [CLSS] presents as neurogenic claudication. CLSS can also be found radiologically in asymptomatic patients. The major aim of this study was to comprehensively analyze MRI-findings in patients with neurogenic claudication. MRI of 64 consecutive patients [average age of 63.5 +/- 14 year [Mean +/- SD], 34 patients [53%] were female] with suspected spinal claudication was included in this retrospective analysis. CLSS was considered to be present whenever dural sac had an AP-diameter < 10 mm and cross-sectional area classification of severity of CLSS was proposed. CLSS was found in 21 patients [32.8%]. Patients with CLSS were older than those with no CLSS [mean 70 versus 63 year; p= 0.02]. No correlation was observed between the occurrence of spinal stenosis and the patient's gender [57% were female; p=0.65]. Almost half of patients referred by orthopaedic surgeons showed to have CLSS compared with 17% of patients referred by other physicians [p=0.02]. No correlation was found between the severity of spinal stenosis and the patient's age and gender, level of stenosis and the referring physicians [p= 0.956, 0.179, 0.310, and 0.491 respectively]. Degenerative spondylolisthesis and Modic changes type I was encountered more frequently in patients with CLSS but the difference was statistically non-significant. Sciatica occurs equally in patients with CLSS and in patients with disc extrusion compared with patients whose MRI did not show CLSS or disc extrusion. Patients with neurogenic claudication should undergo MRI. MRI enables measurement of the cross-sectional area of dural sac, classification of severity of CLSS and may help the physician to plan suitable treatment. The referring physician should be aware of other problems that mimic spinal stenosis