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Comparison of Radiologic Signs and Clinical Symptoms of Spinal Stenosis

Lohman, C Martina MD, PhD*; Tallroth, Kaj MD, PhD*; Kettunen, Jyrki A. PT, PhD; Lindgren, Karl-August MD, PhD

doi: 10.1097/

Study Design. Clinical findings of spinal stenosis were compared to graded radiologic findings of dural sac narrowing.

Objectives. To examine the changes of the dural sac area of the lumbar spine on computerized tomography (CT) performed without and with axial loading, and study the correlations between the radiologic findings and clinical symptoms suggestive of spinal stenosis.

Summary of Background Data. Although several studies have been performed regarding the advantage of an external compression device in lumbar CT, to our knowledge, none of these studies have correlated radiologic findings with clinical symptoms.

Methods. The cross-sectional areas of the dural sac at the 3 lowest lumbar intravenous spaces, measured by CT both without and with external compression, were correlated to the clinical symptoms suggestive of spinal stenosis in 117 patients and 351 intervertebral levels.

Results. No statistically significant correlation between the severity of the clinical symptoms of spinal stenosis and dural cross-sectional areas was found. Neither did the use of an external compression device improve the correlation.

Conclusion. Although an external compression simulates the dynamic condition in the back during standing position, it does not eliminate the need to compare the radiologic findings with the clinical symptoms of patients examined because of a suspected narrowing of the spinal canal.

A total of 117 patients clinically suspected of having lumbar spinal stenosis was studied using computerized tomography, with and without external axial compression. The degree of narrowing of the dural sac seen on computerized tomography did not correlate with the severity of clinical findings of spinal stenosis.

From the *Department of Radiology, †Research Unit, and ‡Rehabilitation Unit, ORTON Orthopaedic Hospital, Helsinki, Finland.

Acknowledgment date: October 21, 2004. First revision date: April 30, 2005. Second revision date: October 9, 2005. Acceptance date: October 10, 2005.

The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to C. Martina Lohman, MD, PhD, Department of Radiology, ORTON Orthopaedic Hospital, Tenholantie 10, 00280 Helsinki, Finland; E-mail:

© 2006 Lippincott Williams & Wilkins, Inc.