Correlation Between Imaging Findings And Walking Distance In Patients With Lumbar Spinal Stenosis

Objective Measure the MRI and CT images of patients with lumbar spinal stenosis(LSS),explore the correlation between them and subjective walking distance(SWD),to provide a basis for further defining the risk factors of LSS.Methods From July 2014 to July 2019,patients with L4-5 or L5-S1 spinal stenosis in our hospital were retrospectively collected as the experimental group.The healthy people who underwent lumbar MRI and CT examination in the health management center of our hospital at the same time were selected as the control group.The posteroanterior diameter(PAD),dural sac cross-sectional area(DCSA)and cross-sectional area of the canal(CAC)were measured on T2 weighted images of LSS group and control group.The intervertebral discs of L1 / 2,L2 / 3,L3 / 4,L4 / 5and L5 / S1 were scanned on the CT bone window images,and the facet joint orientations(FO)angles of the three segments were measured.The relative length of the redundant nerve root(RNR)was measured on the median sagittal plane of lumbar T2 WI.LSS group was divided into three subgroups according to SWD value: mild group(> 500m),moderate group(200 ～ 500m),severe group(50 ～ 200m),and extremely severe group(<50m).T test was used for comparison between groups,and Pearson correlation analysis was used for correlation analysis.Results A total of 120 patients diagnosed with LSS were included in the experimental group,including 53 males and 67 females,ranging in age from 50 to 81 years old with an average age of 68.59 years old.A total of108 healthy subjects without LSS symptoms were included in the control group during the same period,including 59 males and 49 females,ranging in age from 29 to 62 years old(这两处是加的年龄范围),with an average age of 43.75 years old.The age of the experimental group was significantly higher than that of the control group(P<0.05).There was no significant difference in sex ratio and BMI between the two groups(P>0.05).The results of DCSA,PAD,CAC and fo showed that there was no significant difference between the experimental group and the control group in L1/2and L2/3 segments(P>0.05),In the comparison of lower lumbar spine(L3～S1),the above imaging parameters in the experimental group were significantly lower than those in the control group(P<0.05).According to the walking distance,120 cases in the experimental group were divided into four subgroups:mild group(>500m),moderate group(200～500m),severe group(50～200m)and very severe group(<50m).There were 18cases(15%)in mild group,30 cases(25%)in moderate group,43 cases(36%)in severe group and 29 cases(24%)in very severe group.In subgroup,with the decrease of SWD distance,the FO value decreased gradually,while the relative length of RNR increased significantly,The differences were statistically significant(P<0.05).There was no significant difference in DCSA,PAD and CAC between the two groups(P>0.05).Pearson correlation analysis showed that FO value was positively correlated with SWD claudication distance(r=0.265,P=0.013);There was no significant correlation between the relative length of RNR and SWD(r=-0.149,P=0.311).Conclusion The results of this study preliminarily suggest that the sagittal FO value of lumbar facet is closely related to the walking ability of LSS.In the future clinical practice,it is necessary to strengthen the measurement and analysis of imaging parameters in order to further prompt the diagnosis and treatment level of LSS.