Erschienen in:
19.01.2018 | Original Article - Spine
Decompressive surgery for lumbar spinal stenosis across the Atlantic: a comparison of preoperative MRI between matched cohorts from the US and Norway
verfasst von:
Amandeep Bhalla, Thomas D. Cha, Clemens Weber, Ulf Nerland, Sasha Gulati, Greger Lønne
Erschienen in:
Acta Neurochirurgica
|
Ausgabe 3/2018
Einloggen, um Zugang zu erhalten
Abstract
Background
There are no uniform guidelines regarding when to operate for Lumbar Spinal Stenosis (LSS). As we apply findings from clinical research from one population to the next, elucidating similarities or differences provides important context for the validity of extrapolating clinical outcomes. The aim of this study was to compare the morphological severity of lumbar spinal stenosis on preoperative MRI in patients undergoing decompressive surgery in Boston, USA, and Trondheim, Norway.
Methods
In this observational retrospective study, we compared morphological severity on MRI before surgical treatment between two propensity score-matched patient populations with single or two-level symptomatic LSS. We assessed the radiographic severity of LSS utilizing the Schizas classification (grade A to D).
Results
Following propensity score matching, demographics are balanced. In the Trondheim cohort, two levels decompression were present in 36.2% of the patients vs. 41.9% in Boston, (p = 0.396). There was no significant difference in grades A to D concerning central stenosis (p = 0.075). When dichotomized in mild/moderate (A/B) and severe /extreme (C/D), there were no significant differences in the rate of levels operated for high-grade stenosis (C/D), 67.6% in the Boston group compare to 78.1% in the Trondheim group (p = 0.088).
Conclusions
Trondheim, Norway, and Boston, US, have similar radiographic thresholds of LSS for offering surgery.