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MRI evaluation of lumbar spinal stenosis: is a rapid visual assessment as good as area measurement?

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Abstract

Background

Lumbar spinal stenosis (LSS) is commonly assessed on MRI by measuring dural sac cross-sectional area (DSCA). A new method, morphological grading A–D, has recently been introduced as an alternative method.

Objective

The aim of this study is to compare these two different methods for assessing LSS on MRI and study their reliability and intercorrelation.

Methods

On pretreatment MRI of 84 patients, two experienced radiologists independently classified level L2/L3, L3/L4 and L4/L5 as no, relative or significant stenosis using both methods. Agreement was analyzed by weighted Kappa. The correlation between the two methods was analysed using Spearman correlation, and visualized in a box plot.

Results

The interobserver agreement (95 % CI) was 0.69 (0.61–0.77) and 0.65 (0.56–0.74), respectively. The intraobserver agreements for DSCA were 0.77 (0.60–0.74) and 0.80 (0.66–0.93). On morphological grading A–D it was 0.78 (0.65–0.92) and 0.81 (0.68–0.94). The correlation coefficient between the two methods was 0.85 (p < 0.001). Grades C and D were under the limit value for significant stenosis using the DSCA.

Conclusions

The study shows that the inter- and intraobserver agreements of DSCA and morphological grading A–D were acceptable and their intercorrelation is strong. Both methods may be used in the MRI evaluation of LSS.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Innlandet Hospital Trust, Anders Sandvigsgt 17, 2609, Lillehammer, Norway

    Greger Lønne

  2. Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway

    Greger Lønne, Lars Gunnar Johnsen, Kjell Arne Kvistad & Øystein P. Nygaard

  3. Department of Radiology, Innlandet Hospital Trust, Lillehammer, Norway

    Bent Ødegård

  4. Department of Orthopaedic Surgery, University Hospital of St. Olav, Trondheim, Norway

    Lars Gunnar Johnsen

  5. Department of Neurosurgery, University Hospital of North Norway, Tromsø, Norway

    Tore K. Solberg

  6. Department of Radiology, University Hospital of St Olav, Trondheim, Norway

    Kjell Arne Kvistad

  7. Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway

    Kjell Arne Kvistad

  8. Department of Neurosurgery, University Hospital of St. Olav, Trondheim, Norway

    Øystein P. Nygaard

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  1. Greger Lønne
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  2. Bent Ødegård
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Correspondence to Greger Lønne.

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Lønne, G., Ødegård, B., Johnsen, L.G. et al. MRI evaluation of lumbar spinal stenosis: is a rapid visual assessment as good as area measurement?. Eur Spine J 23, 1320–1324 (2014). https://doi.org/10.1007/s00586-014-3248-4

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  • DOI: https://doi.org/10.1007/s00586-014-3248-4

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