Irreversibility of Nerve Root Sedimentation Sign in Lumbar Spinal Stenosis After Decompression Surgery: Incidence and Risk Factors
Background. The nerve root sedimentation sign (Sed-sign) is a new diagnostic test for lumbar spinal stenosis. However, few studies have evaluated radiographical outcomes of positive Sed-sign after decompression surgery. The current study aims to evaluate the radiographicaland clinical outcomes of Sed-signafter decompression surgery among a relatively large sample size
Methods. Patients with positive Sed-sign who underwent transforaminal lumbar interbody fusion (TLIF) surgery were reviewed. Based on postoperative MRI scans, patients with negative or irreversible Sed-sign were assigned to the reversible (R) or irreversible (Ir) groups, respectively. Demographics, radiographic parameters, and health-related quality of life (HRQOL) were evaluated.
Results. The R and Ir groups were comprised of 67 and 15 patients, respectively. There were no significant differences between two groups in terms of mean age, sex, postoperative complications as well as mean follow-up time (all P>0.05). After surgery, disc height (DH), foramina height (FH), and segmental lordosis (SL) in both groups were restored. At the latest follow-up, the smallest cross-sectional area (CSA) was significantly increased when compared with preoperatively (P<0.05). The CSA value and correction rate in the R-group was considerably higher than in the Ir-group (P=0.002 and P=0.007). Both groups had improved HRQOL after TLIF surgery; however, the Oswestry disability index, Zürich Claudication Questionnaire, and visual analog scale for back and leg pain were higher in the Ir vs. R groups (P<0.05). Multiple logistic regression analysis revealed that a postoperative CSA less than 131.4 mm2 was a risk factor for the irreversibility of Sed-sign.
Conclusion.TLIF surgery resulted in reversibility of positive Sed-sign for most patients. The irreversibility of Sed-sign was associated with poor clinical outcomes. Independent risk factor for the irreversibility of Sed-sign was CSA less than 131.4 mm2.
Figure 1
Posted 28 May, 2020
Irreversibility of Nerve Root Sedimentation Sign in Lumbar Spinal Stenosis After Decompression Surgery: Incidence and Risk Factors
Posted 28 May, 2020
Background. The nerve root sedimentation sign (Sed-sign) is a new diagnostic test for lumbar spinal stenosis. However, few studies have evaluated radiographical outcomes of positive Sed-sign after decompression surgery. The current study aims to evaluate the radiographicaland clinical outcomes of Sed-signafter decompression surgery among a relatively large sample size
Methods. Patients with positive Sed-sign who underwent transforaminal lumbar interbody fusion (TLIF) surgery were reviewed. Based on postoperative MRI scans, patients with negative or irreversible Sed-sign were assigned to the reversible (R) or irreversible (Ir) groups, respectively. Demographics, radiographic parameters, and health-related quality of life (HRQOL) were evaluated.
Results. The R and Ir groups were comprised of 67 and 15 patients, respectively. There were no significant differences between two groups in terms of mean age, sex, postoperative complications as well as mean follow-up time (all P>0.05). After surgery, disc height (DH), foramina height (FH), and segmental lordosis (SL) in both groups were restored. At the latest follow-up, the smallest cross-sectional area (CSA) was significantly increased when compared with preoperatively (P<0.05). The CSA value and correction rate in the R-group was considerably higher than in the Ir-group (P=0.002 and P=0.007). Both groups had improved HRQOL after TLIF surgery; however, the Oswestry disability index, Zürich Claudication Questionnaire, and visual analog scale for back and leg pain were higher in the Ir vs. R groups (P<0.05). Multiple logistic regression analysis revealed that a postoperative CSA less than 131.4 mm2 was a risk factor for the irreversibility of Sed-sign.
Conclusion.TLIF surgery resulted in reversibility of positive Sed-sign for most patients. The irreversibility of Sed-sign was associated with poor clinical outcomes. Independent risk factor for the irreversibility of Sed-sign was CSA less than 131.4 mm2.
Figure 1