Multiplanar reconstruction computed tomography of lumbar spinal stenosis in correlation with surgical findings: Initial experience.

ABSTRACT

Lumbar spinal stenosis is a debilitating illness affecting middle-aged and elderly people. There are several imaging modalities available for use in affirming the diagnosis. The CT provides excellent osseous detail of osteophyte, fracture and location of bony abnormality and extension to adjacent soft tissue. New spiral CT technology allows multiplanar images to be obtained quickty and easily. Among these, multiplanar reconstruction computed tomography (MPR-CT) is the specific means to assess narrowed lumber spinal canal. This present work was done in order to evaluate the reliability of MPR-CT in diagnosing lumber spinal stenosis by correlation with operative finding. From July to December 2002, MPR-CT was done on 10 patients and evaluated by a well-known radiologist. Seven patients were approached surgically and the remaining three treated medically. Subsequently, the following variables were analyzed central canal stenosis, lateral canal stenosis, fornminal stenosis, dise herniation, nerve root compression, ligamentum flavum hypertrophy and spondylolisthesis. The results of MPR-CT were in good correlation with finding from surgical exploration; the positive predictive values of central canal atenosis, lateral canal stenosis and foraminal stenosis were 77.7%, 75% and 50% respectively which were higher than those for disc herniation or nerve root compression. Typical claudication was found in 10% of the cases and the most common affected level was L4-L5. Therefore, MPR-CT which composed of axial, coronal and sagittal views was shown to be an application imaging modality because of its reliability.