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A novel MRI classification system for congenital functional lumbar spinal stenosis predicts the risk for tandem cervical spinal stenosis

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Abstract

Purpose

The purpose of this study was to develop a simple and clinically useful morphological classification system for congenital lumbar spinal stenosis using sagittal MRI, allowing clinicians to recognize patterns of lumbar congenital stenosis quickly and be able to screen these patients for tandem cervical stenosis.

Methods

Forty-four subjects with an MRI of both the cervical and lumbar spine were included. On the lumbar spine MRI, the sagittal canal morphology was classified as one of three types: Type I normal, Type II partially narrow, Type III globally narrow. For the cervical spine, the Torg-Pavlov ratio on X-ray and the cervical spinal canal width on MRI were measured. Kruskal–Wallis analysis was done to determine if there was a relationship between the sagittal morphology of the lumbar spinal canal and the presence of cervical spinal stenosis.

Results

Subjects with a type III globally narrow lumbar spinal canal had a significantly lower cervical Torg-Pavlov ratio and smaller cervical spinal canal width than those with a type I normal lumbar spinal canal.

Conclusion

A type III lumbar spinal canal is a globally narrow canal characterized by a lack of spinal fluid around the conus. This was defined as “functional lumbar spinal stenosis” and is associated with an increased incidence of tandem cervical spinal stenosis.

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Correspondence to Carola F. van Eck.

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The authors declare that they have no conflict of interest.

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The authors did not receive any outside funding or grants directly related to the research presented in this manuscript. The authors state that this manuscript is an original work only submitted to this journal. The authors hold the rights to all the material presented in this manuscript. All authors contributed to the preparation of this work. This study was approved by our institutional review board (IRB).

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van Eck, C.F., Spina III, N.T. & Lee, J.Y. A novel MRI classification system for congenital functional lumbar spinal stenosis predicts the risk for tandem cervical spinal stenosis. Eur Spine J 26, 368–373 (2017). https://doi.org/10.1007/s00586-016-4657-3

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  • DOI: https://doi.org/10.1007/s00586-016-4657-3

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