Functional outcome analysis of lumbar canal stenosis patients post decompression and posterior stabilization with stenosis grading using magnetic resonance imaging

Abstract

Lumbar canal stenosis (LCS) is a condition that can potentially cause disability. It often occurs in aging populations. The aim of this study was to analyze the correlation between the clinical outcomes of postoperative patients and classifications that were based on MRI assessments. This prospective cohort study was carried out at Cipto Mangunkusumo General Hospital from January to July 2016 using consecutive sampling. Thirty-eight patient samples were obtained, all of whom were managed with the same surgical technique of decompression and posterior stabilization. The patients were categorized in four types based on MRI examination using the Schizas classification. Pre- and post-treatment (three months and six months) assessments of the patients were conducted according to Visual Analogue Scale (VAS), the Oswestry Disability Index (ODI), the Japanese Orthopedic Association Score (JOA), and the Roland-Morris Disability Questionnaire (RMDQ). The statistical analysis was performed using the statistical program for social science (SPSS) v.19. The average age of the patients in this sample was 58.92 years (range 50–70 years). There were 16 males and 22 females. Most patients were classified as type C (21 subjects) based on MRI examination. The improvement in the clinical scores of male subjects was better than in the female subjects. Significant differences were found in the six-month postoperative VAS (p = 0.003) and three-month postoperative JOA scores (p = 0.029). The results at follow-up showed that the VAS, ODI, JOA and RMDQ scores were improved. There were no statistical differences between the MRI-based classification and the clinical outcomes at preoperative, three and six months postoperative according to VAS (p = 0.451, p = 0.738, p = 0.448), ODI (p = 0.143, p = 0.929, p = 0.796), JOA (p = 0.157, p = 0.876, p = 0.961), and RMDQ (p = 0.065, p = 0.057, p = 0.094). There was clinical improvement after decompression and posterior stabilization in lumbar canal stenosis, which was manifested at three and six month post-operation follow-up in the VAS ODI, JOA and RMDQ scores. There was no association between the degree of LCS and VAS, ODI, JOA and RMDQ scores.