Correlation between MRI Grading System and Surgical Findings for Lumbar Foraminal Stenosis.
10.3340/jkns.2016.1010.004
- Author:
Tae Seok JEONG
1
;
Yong AHN
;
Sang Gu LEE
;
Woo Kyung KIM
;
Seong SON
;
Jung Hwa KWON
Author Information
1. Department of Neurosurgery, Gachon University Gil Medical Center, Incheon, Korea. ns-ay@hanmail.net
- Publication Type:Original Article
- Keywords:
Spinal stenosis;
Lumbar vertebrae;
Magnetic resonance imaging;
Foraminotomy;
Surgery
- MeSH:
Constriction, Pathologic*;
Female;
Foraminotomy;
Humans;
Lumbar Vertebrae;
Magnetic Resonance Imaging*;
Spinal Stenosis;
Spine
- From:Journal of Korean Neurosurgical Society
2017;60(4):465-470
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: Magnetic resonance imaging (MRI) grading systems using sagittal images are useful for evaluation of lumbar foraminal stenosis. We evaluated whether such a grading system is useful as a diagnostic tool for surgery. METHODS: Between July 2014 and June 2015, 99 consecutive patients underwent unilateral lumbar foraminotomy for lumbar foraminal stenosis. Surgically confirmed foraminal stenosis and the contralateral, asymptomatic neuroforamen were assessed based on a 4-point MRI grading system. Two experienced researchers independently evaluated the MR sagittal images. Interobserver agreement and intraobserver agreement were analyzed using κ statistics. RESULTS: The mean age of patients (54 women, 45 men) was 62.5 years. A total of 101 levels (202 neuroforamens) were evaluated. MRI grades for operated neuroforamens were as follows: Grade 0 in 0.99%, Grade 1 in 5.28%, Grade 2 in 14.85%, and Grade 3 in 78.88%. Interobserver agreement was moderate for operated neuroforamens (κ=0.511) and good for asymptomatic neuroforamens (κ=0.696). Intraobserver agreement by reader 1 for operated neuroforamens was good (κ=0.776) and that for asymptomatic neuroforamens was very good (κ=0.831). In terms of lumbar level, interobserver agreement for L5–S1 (κ=0.313, fair) was relatively lower than the other level (κ=0.804, very good). CONCLUSION: MRI grading system for lumbar foraminal stenosis is thought to be useful as a diagnostic tool for surgery in the lumbar spine; however, it is less reliable for symptomatic L5–S1 foraminal stenosis than for other levels. Thus, various clinical factors as well as the MRI grading system are required for surgical decision-making.
