RESUMO
This study examines different morphologic measurements in the evaluation of patients with lumbar spinal stenosis. Preoperative CT scans from 24 patients who underwent surgery for central lumbar stenosis were analyzed. No correlation was observed between the size of the bony spinal canal and the size of the dural sac. A new measurement, the transverse area of the dural sac, is introduced. Normal values are provided. Correlation between the cross-sectional area of the dural sac and the anteroposterior diameter of the dural sac was excellent.
Assuntos
Vértebras Lombares/diagnóstico por imagem , Canal Medular/diagnóstico por imagem , Estenose Espinal/diagnóstico por imagem , Adulto , Idoso , Dura-Máter/diagnóstico por imagem , Dura-Máter/patologia , Feminino , Seguimentos , Humanos , Vértebras Lombares/patologia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Canal Medular/patologia , Estenose Espinal/patologia , Tomografia Computadorizada por Raios XRESUMO
In order to evaluate radiographic methods for diagnosing central lumbar stenosis, we reviewed the computed tomography scans and myelograms of twenty-four patients who underwent surgical decompression for central lumbar stenosis. In the diagnosis of central lumbar stenosis, the measurement of the anterior-posterior diameter of the osseous canal by computed tomography was less reliable than the measurement of the dural sac by myelography. The dimensions of the canal derived from computed tomography provided a correct diagnosis in 20 per cent of the patients, while myelography was accurate 83 per cent of the time. The effectiveness of computed tomography was improved when the cross-sectional area of the dural sac was measured. We suggest that a narrow dural sac, demonstrated by myelography or by computed tomography, reliably indicates central spinal stenosis.