• Clemens Weber, Charalampis Giannadakis, Vidar Rao, Asgeir S Jakola, Ulf Nerland, Øystein P Nygaard, Tore K Solberg, Sasha Gulati, and Ole Solheim.
• *Department of Neurosurgery, Stavanger University Hospital, Stavanger, Norway†Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway‡National Advisory Unit on Spinal Surgery, St. Olavs University Hospital, Trondheim, Norway§Department of Neurosurgery, St. Olavs University Hospital, Trondheim, Norway¶Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden||Norwegian Registry for Spine Surgery (NORspine), University Hospital of Northern Norway, Tromsø, Norway#Department of Neurosurgery, University Hospital of Northern Norway, Tromsø, Norway**Norwegian Centre of Competence in Deep Brain Stimulation for Movement Disorders, St. Olavs University Hospital, Trondheim, Norway††National Competence Center for Ultrasound and Image Guided Therapy, St. Olavs University Hospital, Trondheim, Norway.
• Spine. 2016 Jan 1; 41 (2): E78-83.

Study DesignObservational multicenter study.ObjectiveTo evaluate if the severity of lumbar spinal stenosis (LSS) on magnetic resonance imaging (MRI) correlates with preoperative disability, pain, or surgical outcomes.Summary Of Background DataSurgeons use the morphological appearance of LSS on MRI for clinical decision making. However, the associations between radiological severity of LSS and disability, pain, or surgical outcomes remain unclear.MethodsEvaluation of severity of LSS on preoperative MRI according to the Schizas morphological classification. Patient and treatment data were retrieved from the Norwegian Registry for Spine Surgery. Preopertaive outcome measures were Oswestry disability index (ODI) and numeric rating scale (NRS) scores for back and leg pain. Postopertive outcome measures were ODI and NRS scores for back and leg pain at 1 year, changes in ODI and NRS scores after treatment, duration of surgery, length of hospital stay, and perioperative complications.ResultsOf 202 patients included, 7 were found to have mild stenosis, 38 had moderate stenosis, 108 had severe stenosis, and 49 had extreme stenosis. The radiological severity of LSS was not linked to preoperative ODI (P = 0.089), NRS back pain (P = 0.273), or NRS leg pain (P = 0.282) scores. There were no differences in ODI (P = 0.933), NRS back pain (P = 0.652), or NRS leg pain (P = 0.912) scores after 1 year. The radiological severity of stenosis was not associated with change in ODI (P = 0.494), NRS back pain (P = 0.235), NRS leg pain (P = 0.790), duration of surgery (P = 0.661), length of hospital stay (P = 0.739), or perioperative complication rates (P = 0.467).ConclusionAmong patients who underwent decompressive surgery for LSS, radiological severity of stenosis was not associated with preoperative disability and pain, or clinical outcomes 1 year after surgery. In this patient group, the radiological severity of LSS has no clear clinical correlation and should therefore not be overemphasized in clinical decision making.Level Of Evidence2.

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