Association Between Lumbar Muscle Atrophy, Sagittal Pelvic Alignment and Stenosis Grade in Patients With Degenerative Lumbar Spinal Stenosis

University Hospital, Basel, Switzerland165 enrolled

Overview

This study is to evaluate the correlation between muscle atrophy (MA), sagittal alignment, and stenosis degree in patients with lumbar spinal Stenosis (LSS). From existing radiological images, specific radiographic parameters will be extracted. General Information (Age, sex, levels of stenosis, duration of symptoms) will be extracted from patient files.

Study Type

OBSERVATIONAL

Enrollment

165

Conditions

Lumbar Spinal Stenosis (LSS)

Interventions

radiographic data collectionOTHER

From existing radiological Images (upright standing X-ray and supine MRI of the lumbar spine), specific radiographic parameters will be extracted

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Diagnosis of degenerative lumbar spinal stenosis * Upright standing sagittal plane X-ray of lumbar spine with clear visibility of pelvis sacrum and femoral head * MRI of the lumbar region with clear visibility of different muscle atrophy grade * Consent that health related information can be used for research was signed Exclusion Criteria: * Other spinal disease such as severe scoliosis, fracture, spondylolisthesis and ankylosing spondylitis. * Neuromuscular diseases such as M.Parkinson or multiple sclerosis * Previous surgery of the spine * Infection and/or malignancy tumor with involvement of the bony or soft tissue structures of the spine * Presence of a documented consent dissent.

Locations (1)

Orthopaedics and Traumatology, University Hospital Basel

Basel, Switzerland

Outcomes

Primary Outcomes

Severity of muscle atrophy (MA) from supine Magnetic Resonance Imaging (MRI) of lumbar spine

Muscle atrophy stage will be observed using Goutallier classification * Stage 0: No fatty infiltration * Stage 1: Few fatty streaks within the muscle * Stage 2: Less than 50% fat within the muscle * Stage 3: 50% of fat within the muscle * Stage 4: more than 50% fat with in the muscle. The MA stage will be observed in MRI of 5 lumbar disc levels (L1-S1). The MA stage of patients will be calculated as average stage of five lumbar segments.

Time frame: single time-point at baseline

Pelvic incidence (PI): Pelvic alignment from standard upright standing sagittal plane X-ray of lumbar spine with clear visibility of pelvis sacrum and femoral heads

Pelvic incidence (PI): The angle between the line perpendicular to the sacral endplate at its midpoint and a line connecting this point to the axis of the femoral head.

Time frame: single time-point at baseline

Severity of stenosis from supine MRI of lumbar spine

Stenosis grade will be observed using Schizas classification (Schizas et al., 2010) * Grade 1: Dural sac party occupied by the rootlets; Cerebrospinal fluid clearly visible; No stenosis * Grade 2: Rootlets occupy whole dural sac; Some cerebrospinal fluid visible; Moderate stenosis. * Grade 3: Rootlets not visible; No cerebrospinal fluid visible; Epidural fat posteriorly; Severe stenosis. * Grade 4: Rootlets not visible; No cerebrospinal fluid; No epidural fat; Extreme Stenosis. The most severe level will be regarded as the stenosis grade of the patients.

Time frame: single time-point at baseline

Pelvic tilt (PT): Pelvic alignment from standard upright standing sagittal plane X-ray of lumbar spine with clear visibility of pelvis sacrum and femoral heads

Pelvic tilt (PT): The angle formed by a vertical line through the center of the femoral heads and the line from the center of the femoral axis and the midpoint of the sacral end plate.

Time frame: single time-point at baseline

Data from ClinicalTrials.gov

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