Correlation of listhesis on upright radiographs and central lumbar spinal canal stenosis on supine MRI: is it possible to predict lumbar spinal canal stenosis?

on behalf of the LSOS working group

Research output: Contribution to journalArticle

Abstract

Objective: To investigate whether upright radiographs can predict lumbar spinal canal stenosis using supine lumbar magnetic resonance imaging (MRI) and to investigate the detection performance for spondylolisthesis on upright radiographs compared with supine MRI in patients with suspected lumbar spinal canal stenosis (LSS). Materials and Methods: In this retrospective study, conventional radiographs and MR images of 143 consecutive patients with suspected LSS (75 female, mean age 72 years) were evaluated. The presence and extent of listhesis (median ± interquartile range) were assessed on upright radiographs and supine MRI of L4/5. In addition, the grade of central spinal stenosis of the same level was evaluated on MRI according to the classification of Schizas and correlated with the severity/grading of anterolisthesis on radiographs. Results: Anterolisthesis was detected in significantly more patients on radiographs (n = 54; 38%) compared with MRI (n = 28; 20%), p < 0.001. Pairwise comparison demonstrated a significantly larger extent of anterolisthesis on radiographs (9 ± 5 mm) compared with MRI (5 ± 3 mm), p < 0.001. A positive correlation was found regarding the extent of anterolisthesis measured on radiographs and the grade of stenosis on MRI (r = 0.563, p < 0.001). Applying a cutoff value of ≥5 mm anterolisthesis on radiographs results in a specificity of 90% and a positive predictive value of 78% for the detection of patients with LSS, as defined by the Schizas classification. Conclusion: Upright radiographs demonstrated more and larger extents of anterolisthesis compared with supine MRI. In addition, in patients with suspected LSS, the extent of anterolisthesis on radiographs (particularly ≥5 mm) is indicative of LSS and warrants lumbar spine MRI.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalSkeletal Radiology
DOIs
StateAccepted/In press - Apr 13 2018
Externally publishedYes

Fingerprint

Spinal Stenosis
Spinal Canal
Magnetic Resonance Imaging
Spondylolisthesis
Pathologic Constriction
Spine
Retrospective Studies

Keywords

  • Anterolisthesis
  • Claudication
  • Degenerative spinal changes
  • Listhesis
  • Lower back pain
  • Lumbar spine
  • Magnetic resonance imaging
  • Radiography
  • Spinal canal stenosis
  • Spine
  • Spondylolisthesis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{89b2bdbfbb44487dab334915c1f0f2c6,
title = "Correlation of listhesis on upright radiographs and central lumbar spinal canal stenosis on supine MRI: is it possible to predict lumbar spinal canal stenosis?",
abstract = "Objective: To investigate whether upright radiographs can predict lumbar spinal canal stenosis using supine lumbar magnetic resonance imaging (MRI) and to investigate the detection performance for spondylolisthesis on upright radiographs compared with supine MRI in patients with suspected lumbar spinal canal stenosis (LSS). Materials and Methods: In this retrospective study, conventional radiographs and MR images of 143 consecutive patients with suspected LSS (75 female, mean age 72 years) were evaluated. The presence and extent of listhesis (median ± interquartile range) were assessed on upright radiographs and supine MRI of L4/5. In addition, the grade of central spinal stenosis of the same level was evaluated on MRI according to the classification of Schizas and correlated with the severity/grading of anterolisthesis on radiographs. Results: Anterolisthesis was detected in significantly more patients on radiographs (n = 54; 38{\%}) compared with MRI (n = 28; 20{\%}), p < 0.001. Pairwise comparison demonstrated a significantly larger extent of anterolisthesis on radiographs (9 ± 5 mm) compared with MRI (5 ± 3 mm), p < 0.001. A positive correlation was found regarding the extent of anterolisthesis measured on radiographs and the grade of stenosis on MRI (r = 0.563, p < 0.001). Applying a cutoff value of ≥5 mm anterolisthesis on radiographs results in a specificity of 90{\%} and a positive predictive value of 78{\%} for the detection of patients with LSS, as defined by the Schizas classification. Conclusion: Upright radiographs demonstrated more and larger extents of anterolisthesis compared with supine MRI. In addition, in patients with suspected LSS, the extent of anterolisthesis on radiographs (particularly ≥5 mm) is indicative of LSS and warrants lumbar spine MRI.",
keywords = "Anterolisthesis, Claudication, Degenerative spinal changes, Listhesis, Lower back pain, Lumbar spine, Magnetic resonance imaging, Radiography, Spinal canal stenosis, Spine, Spondylolisthesis",
author = "{on behalf of the LSOS working group} and Tim Finkenstaedt and {Del Grande}, Filippo and Nicolae Bolog and Ulrich, {Nils H.} and Sina Tok and Burgstaller, {Jakob M.} and Johann Steurer and Chung, {Christine B.} and Gustav Andreisek and Sebastian Winklhofer",
year = "2018",
month = "4",
day = "13",
doi = "10.1007/s00256-018-2935-3",
language = "English (US)",
pages = "1--7",
journal = "Skeletal Radiology",
issn = "0364-2348",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Correlation of listhesis on upright radiographs and central lumbar spinal canal stenosis on supine MRI

T2 - is it possible to predict lumbar spinal canal stenosis?

AU - on behalf of the LSOS working group

AU - Finkenstaedt, Tim

AU - Del Grande, Filippo

AU - Bolog, Nicolae

AU - Ulrich, Nils H.

AU - Tok, Sina

AU - Burgstaller, Jakob M.

AU - Steurer, Johann

AU - Chung, Christine B.

AU - Andreisek, Gustav

AU - Winklhofer, Sebastian

PY - 2018/4/13

Y1 - 2018/4/13

N2 - Objective: To investigate whether upright radiographs can predict lumbar spinal canal stenosis using supine lumbar magnetic resonance imaging (MRI) and to investigate the detection performance for spondylolisthesis on upright radiographs compared with supine MRI in patients with suspected lumbar spinal canal stenosis (LSS). Materials and Methods: In this retrospective study, conventional radiographs and MR images of 143 consecutive patients with suspected LSS (75 female, mean age 72 years) were evaluated. The presence and extent of listhesis (median ± interquartile range) were assessed on upright radiographs and supine MRI of L4/5. In addition, the grade of central spinal stenosis of the same level was evaluated on MRI according to the classification of Schizas and correlated with the severity/grading of anterolisthesis on radiographs. Results: Anterolisthesis was detected in significantly more patients on radiographs (n = 54; 38%) compared with MRI (n = 28; 20%), p < 0.001. Pairwise comparison demonstrated a significantly larger extent of anterolisthesis on radiographs (9 ± 5 mm) compared with MRI (5 ± 3 mm), p < 0.001. A positive correlation was found regarding the extent of anterolisthesis measured on radiographs and the grade of stenosis on MRI (r = 0.563, p < 0.001). Applying a cutoff value of ≥5 mm anterolisthesis on radiographs results in a specificity of 90% and a positive predictive value of 78% for the detection of patients with LSS, as defined by the Schizas classification. Conclusion: Upright radiographs demonstrated more and larger extents of anterolisthesis compared with supine MRI. In addition, in patients with suspected LSS, the extent of anterolisthesis on radiographs (particularly ≥5 mm) is indicative of LSS and warrants lumbar spine MRI.

AB - Objective: To investigate whether upright radiographs can predict lumbar spinal canal stenosis using supine lumbar magnetic resonance imaging (MRI) and to investigate the detection performance for spondylolisthesis on upright radiographs compared with supine MRI in patients with suspected lumbar spinal canal stenosis (LSS). Materials and Methods: In this retrospective study, conventional radiographs and MR images of 143 consecutive patients with suspected LSS (75 female, mean age 72 years) were evaluated. The presence and extent of listhesis (median ± interquartile range) were assessed on upright radiographs and supine MRI of L4/5. In addition, the grade of central spinal stenosis of the same level was evaluated on MRI according to the classification of Schizas and correlated with the severity/grading of anterolisthesis on radiographs. Results: Anterolisthesis was detected in significantly more patients on radiographs (n = 54; 38%) compared with MRI (n = 28; 20%), p < 0.001. Pairwise comparison demonstrated a significantly larger extent of anterolisthesis on radiographs (9 ± 5 mm) compared with MRI (5 ± 3 mm), p < 0.001. A positive correlation was found regarding the extent of anterolisthesis measured on radiographs and the grade of stenosis on MRI (r = 0.563, p < 0.001). Applying a cutoff value of ≥5 mm anterolisthesis on radiographs results in a specificity of 90% and a positive predictive value of 78% for the detection of patients with LSS, as defined by the Schizas classification. Conclusion: Upright radiographs demonstrated more and larger extents of anterolisthesis compared with supine MRI. In addition, in patients with suspected LSS, the extent of anterolisthesis on radiographs (particularly ≥5 mm) is indicative of LSS and warrants lumbar spine MRI.

KW - Anterolisthesis

KW - Claudication

KW - Degenerative spinal changes

KW - Listhesis

KW - Lower back pain

KW - Lumbar spine

KW - Magnetic resonance imaging

KW - Radiography

KW - Spinal canal stenosis

KW - Spine

KW - Spondylolisthesis

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U2 - 10.1007/s00256-018-2935-3

DO - 10.1007/s00256-018-2935-3

M3 - Article

C2 - 29651713

AN - SCOPUS:85045287422

SP - 1

EP - 7

JO - Skeletal Radiology

JF - Skeletal Radiology

SN - 0364-2348

ER -