Decision-making in lumbar spinal stenosis: A survey on the influence of the morphology of the dural sac

摘要: Surgical decision-making in lumbar spinal stenosis involves assessment of clinical parameters and the severity the radiological stenosis. We suspected that surgeons based surgical decisions more on dural sac cross-sectional area (DSCA) than on the morphology sac. carried out a survey among members of three European spine societies. The axial T2-weighted MR images from ten patients with varying degrees DSCA morphological grades according to recently described morphological classification of stenosis, values disclosed half the assessed images, were used for evaluation. provided clinical scenario accompany which shown 142 responding physicians, mainly orthopaedic but also some neurosurgeons and others directly involved treating disorders. As primary outcome we number respondents who would proceed surgery given or grade. Substantial agreement was observed, severe extreme stenosis as defined by grade leading surgery. This decision not dependent years practice, medical density specialty. Disclosing did alter operative decision-making. In all, 40 respondents (29%) had prior knowledge of grading system, their responses showed no difference from those not. This study suggests the participants less influenced morphological appearance Classifying stenosis rather than surface measurements appears be consistent current clinical practice.