Clinical Value of Nerve Root Sedimentation Sign in Lumbar Spinal Stenosis

ABSTRACT

STUDY DESIGN: A retrospective study. OBJECTIVES: To assess the diagnostic value of the sedimentation sign seen on MRI with lumbar spinal stenosis and to compare postoperative clinical results. SUMMARY OF LITERATURE REVIEW Nerve root sedimentation sign is an additional tool to diagnose lumbar spinal stenosis. MATERIALS AND METHODS: There were 302 patients enrolled that had been diagnosed with lumbar spinal stenosis by MRI, which were reviewed to identify a sedimentation sign and all underwent the operative treatment. There were 142 patients who could not have their spinal stenosis diagnosis confirmed by MRI, and thus were selected as the control group to estimate the diagnostic value of nerve root sedimentation sign. Correlation with the duration of preoperative symptoms and the number of involved segments were compared and analyzed between sedimentation sign positive (Group I) and negative (Group II). We estimated Million Visual Analogue Score (MVAS) and Korean Oswestry Disability Index (KODI) for the assessment of the pain and the functional disability. RESULTS: A positive sedimentation sign was found in 265 patients (87.7%) and diagnostic value was statistically significant (P<0.001). The involvement of 2 or more segments was significantly correlated with the sedimentation sign in the positive group (P<0.001). MVAS presented the improvement of 64.5+/-4.6%, KODI, 62.9+/-3.9% after surgical treatment in Group I. In Group II, each score showed improvement of 34.6+/-2.3% (MVAS), 37.1+/-1.8% (KODI). The improvement of these scores in Group I was better than in Group II. CONCLUSIONS: The nerve root sedimentation sign is an additional tool to diagnose lumbar spinal stenosis and the considerable factor to decide the operation.