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The Predictive Value of Preoperative Myelography in Lumbar Spinal Stenosis

Herno, Arto, MD*; Airaksinen, Olavi, MD, PhD*; Saari, Tapani, MD; Miettinen, Heikki, MD

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Study Design Restrospective follow-up study on the significance of myelographic findings on the postoperative results of patients with lumbar canal stenosis is not well defined.

Objectives The authors studied the predictive influence of preoperetive myelography on the outcome of patients with surgically treated lumbar spinal stenosis, defined by an uppar limit of anteroposterior diameter of the dural sac on the lateral myelogram film of equal la or less than 12 mm.

Summary of Background Data Patients with prior lumbar surgery were excluded. There were 251 patients [women 44% and men 56%] with a mean age of 55 years and a mean follow-up time of 4.2 years.

Methods Patients with complete block or subtotal block on myalography were included in the block stenosis group, patients with an anteroposterior diameter of less than 10 mm were included in the absolute stenosis group and patients with an anteroposterior diameter of 10–12 mm were included in the relative stenosis group.

Results The proportion of good-to-excellent outcomes was 76% in block stenosis, 56% in absolute stenosis, and 61% in relative stenosis. In the multivariate analysis, the pre-preoperative variables that correlated with good outcome were block stenosis and male sex.

Conclusions The severity of myelographic findings is significantly related to the outcome of patients who underwent surgeries for lumbar canal stenosis.

*Departments of Physical Medicine and Rehabilitation, Kuopio University Hospital, Kuopio, Finland.

†Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.

‡Medicine, Kuopio University Hospital, Kuopio, Finland.

© Lippincott-Raven Publishers.