Abstract

Introduction: Although a lot of studies had been carried out in lumbar spinal stenosis (LCS) the absolute predictors for surgical management and predictable post-operative outcome were not evaluated using imaging studies. Hence it was considered worthwhile to look for this relationship using imaging studies and clinical analysis pre and post-operativelyMethods: Fifty patients in the age group of 25 to 70 years who underwent surgical treatment for lumbar spinal Stenosis at our hospital were included in the study. Preoperatively the cases were evaluated with the Oswestry disability index. All 50 patients underwent preoperative L-S spine roentgenograms and Magnetic Resonance Imaging. The various stenotic levels were identified. The stenotic dural sac on MRI was measured using the UNIX and AutoCAD software and compared to the deficit. Post-operative neurological status assessment was also carried out using the Oswestry disability index Results:Out of 50 patients, 36 were males and 14 were females and 43 % cases were smokers. The mean preoperative and post-operative Oswestry disability indexes were 71 +/- 4 % and 22 +/- 6 % respectively. All cases had relative to severe stenosis on MRI with the mean dural cross sectional area 75 mm² at L 4-5 and 76 mm² at L5-S1 levels respectively. The various stenotic levels were identified as those with facet hypertrophy, ligamentum flavum hypertrophy and disc prolapse. Laminectomy and disectomy was the commonest procedure performed in 54 % of the cases. The satisfaction level based on the Oswestry disability questionnaire was calculated. Conclusion:Clinico-radiological assessment of lumbar spinal stenosis and evaluation of surgical treatment was done and it showed that there is a correlation between the severity of stenosis on MRI and the neurological deficit. Surgery was beneficial and showed good to excellent results. Category: spine