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Correlation of lumbar lateral recess stenosis in magnetic resonance imaging and clinical symptoms

World Journal of Radiology 2017年第5期9卷 223-229页

作者： Annina SplettstoBer M Fawad Khan Bernd Zimmermann Thomas J Vogl Hanns Ackermann Marcus Middendorp Adel Maataoui radprax mvz Institute for Diagnostic and Interventional Radiology Goethe University Institute of Biostatistics and Mathematical Modeling Goethe University Department of Nuclear Medicine Goethe University

AIM To assess the correlation of lateral recess stenosis(LRS) of lumbar segments L4/5 and L5/S1 and the Oswestry Disability Index(ODI).METHODS Nine hundred and twenty-seven patients with history of low back pain were included in this uncontrolled *** magnetic resonance images(MRI) the lateral recesses(LR) at lumbar levels L4/5 and L5/S1 were evaluated and each nerve root was classified into a 4-point grading scale(Grade 0-3) as normal,not deviated,deviated or *** symptoms and disability were assessed using *** Spearman's rank correlation coefficient was used for statistical analysis(P < 0.05).RESULTS Approximately half of the LR revealed stenosis(grade 1-3;52% at level L4/5 and 42% at level L5/S1) with 2.2% and 1.9% respectively reveal a nerve root *** ODI score ranged from 0%-91.11% with an arithmetic mean of 34.06% ± 16.89%.We observed a very weak statistically significant positive correlation between ODI and LRS at lumbar levels L4/5 and L5/S1,each bilaterally(L4/5 left:rho < 0.105,P < 0.01;L4/5 right:rho < 0.111,P < 0.01;L5/S1 left:rho 0.128,P < 0.01;L5/S1 right:rho < 0.157,P < 0.001).CONCLUSION Although MRI is the standard imaging tool for diagnosing lumbar spinal stenosis,this study showed only a weak correlation of LRS on MRI and clinical *** can be attributed to a number of reasons outlined in this study,underlining that imaging findings alone are not sufficient to establish a reliable diagnosis for patients with LRS.

关键词： Low back pain Lumbar spine Magnetic resonance imaging Lateral recess stenosis Oswestry Disability Score Lumbar spinal canal stenosis

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Does therapist's attitude affect clinical outcome of lumbar facet joint injections?

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World Journal of Radiology 2016年第6期8卷 628-634页

作者： Marcus Middendorp Konstantinos Kollias Hanns Ackermann Annina Splettstoβer Thomas J Vogl M Fawad Khan Adel Maataoui Department of Nuclear Medicine Goethe University Institute for Diagnostic and Interventional Radiology Goethe University Institute of Biostatistics and Mathematical Modeling Goethe University radprax mvz

AIM: To investigate if the clinical outcome of intraarticular lumbar facet joint injections is affected by the therapist's attitude. METHODS: A total of 40 patients with facet jointassociated chronic low back pain were randomly divided into two groups. All patients received computed tomography-guided, monosegmental intra-articular facet joint injections. Following the therapeutic procedure, the patients of the experimental group(EG) held a conversation with the radiologist in a comfortable atmosphere. During the dialog, the patients were encouraged to ask questions and were shown four images. The patients of the control group(CG) left the clinic without any further contact with the radiologist. Outcome was assessed using a pain-based Verbal Numeric Scale at baseline, at 1 wk and at 1, 3, and 6 mo after first treatment. RESULTS: The patient demographics showed no differences between the groups. The patients of the EG received 57 interventional procedures in total, while the patients of the CG received 70 interventional procedures. In both groups, the pain scores decreased significantly over the entire observation period. Compared to the CG, the EG showed a statistically significant reduction of pain at 1 wk and 1 mo post-treatment, while at 3 and 6 mo after treatment, there were no significant differences between both groups. CONCLUSION: Our results show a significant effect on pain relief during the early post-interventional period in the EG as compared to the CG. The basic principle behind the higher efficacy might be the phenomenon of hetero-suggestion.

关键词： Facet joint injection Hetero-suggestion Low back pain Lumbar spine Magnetic resonance imaging Facet joint osteoarthritis

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