Comparison of plain X-ray and MRI findings by determining the sensitivity and specificity in the diagnosis of lumbar spinal stenosis in rural population
DOI:
https://doi.org/10.18203/2320-6012.ijrms20223639Keywords:
MRI, Plain x-ray, Spinal stenosisAbstract
Background: Lumbar spinal stenosis is the most frequent indication for spine surgery. The x-ray and MRI are the choice of investigation. Justified use of radiography can be cost effective in the management of lumbar spinal stenosis. Objective was to evaluate and compare the sensitivity and specificity of the plain x-ray and MRI in the diagnosis of the lumbar spinal stenosis.
Methods: A multicenter cross sectional analytical study was carried out from July 2021 to August 2022 on 70 patients of both sexes aged more than 25 years with chronic low back pain. A descriptive analysis was performed for all data.
Results: In the MRI, 35 (50.0%) cases had diskogenic spinal canal stenosis and 24 (34.3%) had both diskogenic and non diskogenic spinal canal stenosis. The validity of MRI evaluation for only diskogenic spinal canal stenosis was correlated, where the calculated values of plain x-ray were: sensitivity 80.0%, specificity 60.0%, accuracy 77.5%, positive predictive value 93.3% and negative predictive value 30.0%. The validity of MRI evaluation for both diskogenic and non diskogenic spinal canal stenosis was correlated, where the calculated values of plain x-ray were sensitivity 83.3%, specificity 66.7%, accuracy 80.0%, positive predictive value 90.9% and negative predictive value 50.0%.
Conclusions: Plain x-ray is a useful and reliable diagnostic modality for the evaluation, assessment and the subsequent appropriate management of lumbar spinal stenosis.
References
Deyo R. Treatment of lumbar spinal stenosis: a balancing act. Spine J. 2010;10(7):625-7.
NASS Evidence-Based Clinical Guidelines Committee. North American Spine Society. Evidence based clinical guidelines for Multi-disciplinary Spine Care. Diagnosis and Treatment of Degenerative Lumbar Spinal Stenosis. Burr Ridge IL. North American Spine Society; 2007.
Kalichman L, Cole R, Kim D, Li L, Suri P, Guermazi A, et al. Spinal stenosis prevalence and association with symptoms: the Framingham study. Spine J. 2009;9(7):545-50.
Geen J, Edelaar M. The long term of effect of mulyidisciplinary back training: a systematic review. Spine J. 2007;32(2):249-55.
Dillane J, Fry J, Kalton G. Acute back pain- a study from general practice. Br Med J. 1966;2:82-4.
Andersson GB. The epidemiology of spinal stenosis. In: Frymoyer JW, ed. The adult spine: principles and practice, Philadelphia, Lippincot-Raven; 1997:93-111
Boden SD, Davis DO, Dina TS. Abnormal magnetic resonace scans of the lumbar spine in asymptomatic subjects: a prospective investigaton. J Bone Joint Surg. 1990;72:403-8.
Wiesel SW, Tsourmas N, Feffer HL. A study of computer-assisted tomography: the incidence of positive CAT scans in an asymptomatic group of patients. Spine. 1984;9:549.
Buckwalter JA, Saltzman C, Brown T. The impact of osteoarthritis: implications of research. Clin Orthop Relat Res. 2004;427:6-15.
Boos N, Weissbach S, Rohrbach H. Classification of age related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science. Spine. 2002;27:2631-44.
Rothschild B. Lumbar spondylosis. Emedicine publication. 2008. Available from: http://emedicine.medscape.com/article/249036-overview. Accessed on 1 September 2022.
Moreland LW, Lopez MA, Alarcon GS. Spinal stenosis: a comprehensive review of the literature. Semin Arthritis Rheum. 1989;19:127-49.
Sheldon JJ, Russin LA, Gargano FP. Lumbar spinal stenosis: radiographic diagnosis with special reference to transverse axial tomography. Clin Orthop. 1976;115:53-67.
Spivak JM, Degenerative lumbar spinal stenosis. J Bone Joint Surg. 1998;80:1053-66.
Radu AS, Menkes CJ. Update on lumbar spinal stenosis. Retrospective study of 62 patients and review of literature. Rev Rheum Engl Ed. 1998;65:337-45.
Roberson GH, Llewellyn HJ, Traveras JM. The narrow lumbar spinal canal syndrome. Radiology. 1973;107:89-97.
Granier N, Kressel HY, Schiebler ML, Grossman RI, Dalinka MK. Normal and degenerative posterior spinal structures: MR imaging. Radiology. 1987;165(2):517-25
Hamanishi C, Matukura N, Fujita M, Tomihara M, Tanaka SJ. Cross sectional area of the stenotic lumbar dural tube measured from the transverse views of magnetic resonance imaging. J Spine Disord. 1994;7:388-93.
Sasaki K, Magnetic resonance imaging findings of the lumbar root pathway in patients over 50 years old. Eur Spine J. 1995;4(2)71-76.
Wildermuth S, Zanetti M, Duewell S. Lumbar spine: quantitative and qualitative assessment of positional (upright flexion and extension) MR imaging and myelography. Radiology. 1998;207(2):391-8.
Annertz M, Holtas S, Coronqvist S, Jonsson B, Stromqvist B. Isthmic lumbar spondylolisthesis with sciatica: MR imaging versus myelography. Acta Radiol. 1990;31:49-53.
Deutman R, Diercks RL, de Jong TE, van Woerden HH. Isthmic lumbar spondylolisthesis with sciatica: the role of the disc. Eur Spine J. 1995;4:136-8.
Hashimoto M, Watanabe O, Hirano H. Extraforaminal stenosis in the lumbosacral spine: Efficacy of MR imaging in the coronal plane. Acta Radiol. 1996;37:610-3.
Herzog RJ. The radiologic evaluation of lumbar degenerative disk disease and spinal stenosis in patients with back or radicular symptoms. Instr Course Lect. 1992;41:193-203.
Young PY, Alias NAA, Shuaib IL. Correlation of clinical presentation, radiology and magnetic resonance imaging for low back pain- a preliminary survey. J HK Coll Radiol. 2003;6:144-51.
Colhoun E, Mc Call IW, Williams L, Pullicino CVN. Provocation discography as a guide to planning operations on the spine, J Bone Joint Surg. 1988;70:267-71.
Willems PC, Elmans L, Andersen G, van der Schaaf DB, de Kluever M. Provocative discography and lumbar fusion: is preoperative assessment of adjacent discs useful? Spine. 2007;32(10):1094-9.
Krenier S, Summers J, Shaffer WO, Toton J, Baisden J, Hwang S, et al. Diagnosis and treatment of degenerative spinal stenosis. North Am Spine Soc. 2011;14.
