The Study Of Relationship Between The Nerve Root Sedimentation Syndrome And Lumbar Spinal Stenosis

Background: In the diagnosis of LSS, radiologic findings do not always correlatewith clinical symptoms, and additional diagnostic signs are needed. In patients withoutLSS, we observe the sedimentation of lumbar nerve roots to the dorsal part of the duralsac on supine magnetic resonance image scans. In patients with symptomatic andmorphologic central LSS, this sedimentation is rarely seen. We named this phenomenon"sedimentation syndrome" and defined the absence of sedimenting nerve roots aspositive sedimentation syndrome for the diagnosis of LSS.Objective: To evaluate the value of the sedimentation of the disease in the differentialdiagnosis of non-specific low back pain (LBP), and symptomatic lumbar spinal stenosis(LSS).Methods: The study included140cases. Patients in LSS group (n=70) showedclaudication with or without LBP and leg pain, dural representative area <80mm2,walking distance <200m; patients in LBP group (n=70) non-specific low back pain, noleg pain and claudication, the dural sac representative area>120mm2and walkingdistance>1000m. The probability of positive sedimentation syndrome was comparedbetween the two groups.Results: The LSS group of70cases was observed to the positive sedimentationsyndrome in66patients (94%), but none in the LBP group (0). The difference was notstatistically significant between the2groups in VAS pain score. However, patients in the LBP group experienced a higher severity of functional limitation as measured by theODI (65%in LBP group vs61%in LSS group;P <0.05). The LBP group CSA wassignificantly greater than the LSS group, and a significant difference was statisticallysignificant between the two groups (P <0.01). The correlation between ODI and thesmallest CSA of the dural sac was R=0.14(P=0.099) and there is no correlation betweenthem.Conclusion: The positive sedimentation sydrome is extensive and reliable appear inthe LSS case, indicating its availability in clinical practice. A positive sedimentationsydrome of the disease will be diagnosed LSS, the negative sedimentation sydrome mayexclude the LSS.