Published online May 28, 2017. doi: 10.4329/wjr.v9.i5.223
Peer-review started: October 14, 2016
First decision: November 11, 2016
Revised: February 22, 2017
Accepted: March 16, 2017
Article in press: March 17, 2017
Published online: May 28, 2017
To assess the correlation of lateral recess stenosis (LRS) of lumbar segments L4/5 and L5/S1 and the Oswestry Disability Index (ODI).
Nine hundred and twenty-seven patients with history of low back pain were included in this uncontrolled study. On magnetic resonance images (MRI) the lateral recesses (LR) at lumbar levels L4/5 and L5/S1 were evaluated and each nerve root was classified into a 4-point grading scale (Grade 0-3) as normal, not deviated, deviated or compressed. Patient symptoms and disability were assessed using ODI. The Spearman’s rank correlation coefficient was used for statistical analysis (P < 0.05).
Approximately half of the LR revealed stenosis (grade 1-3; 52% at level L4/5 and 42% at level L5/S1) with 2.2% and 1.9% respectively reveal a nerve root compression. The ODI score ranged from 0%-91.11% with an arithmetic mean of 34.06% ± 16.89%. We observed a very weak statistically significant positive correlation between ODI and LRS at lumbar levels L4/5 and L5/S1, each bilaterally (L4/5 left: rho < 0.105, P < 0.01; L4/5 right: rho < 0.111, P < 0.01; L5/S1 left: rho 0.128, P < 0.01; L5/S1 right: rho < 0.157, P < 0.001).
Although MRI is the standard imaging tool for diagnosing lumbar spinal stenosis, this study showed only a weak correlation of LRS on MRI and clinical findings. This can be attributed to a number of reasons outlined in this study, underlining that imaging findings alone are not sufficient to establish a reliable diagnosis for patients with LRS.
Core tip: In the presented study lateral recesses of nearly 1000 patients with low back pain were evaluated on magnetic resonance imaging (MRI) and correlated with patient symptoms. Though MRI is the method of choice for diagnosing lumbar spinal stenosis, we revealed only a very weak correlation of lateral recess stenosis (LRS) and patient symptoms. This can be attributed to numerous reasons outlined in this study, underlining that imaging findings alone are not sufficient for an adequate diagnostic approach of patients with LRS.