Visually Assessed Severity of Lumbar Spinal Canal Stenosis Is Paradoxically Associated With Leg Pain and Objective Walking Ability

Pekka Kuittinen; Petri Sipola; Tapani Saari; Timo Juhani Aalto; Sanna Sinikallio; Sakari Savolainen; Heikki Kröger; Veli Turunen; Ville Leinonen; Olavi Airaksinen


BMC Musculoskelet Disord. 2014;15(348) 

In This Article


Lumbar spinal stenosis (LSS) is the term used commonly to describe patients with symptoms related to the anatomical reduction of the size of the lumbar spinal canal.[1] However, some subjects can have a narrowed canal without presenting any symptoms. Therefore, this peculiarity raised the question of what is the actually role of central canal stenosis in symptomatic patients. The relationship between radiological findings and patient's symptoms has been studied by several authors. These studies have reported that MRI imaging findings did not identify symptomatic from asymptomatic persons.[2–5]

Unfortunately, many previous studies have some methodological limitations related to the assessment of patients' symptoms. Typically, the symptoms have been evaluated retrospectively from the patient records or otherwise rated without a standard methodology. The use of the standardized Oswestry Disability Index (ODI),[6] Visual analog pain scale (VAS),[7] Beck Depression Inventory (BDI),[8] and specific back pain at rest and leg pain at walking items of the Numerical Rating Scale (LBP- and LP-NRS-11)[9] have improved the accuracy and reproducibility of patients symptom and functional disability grading.

The purpose of this study was to investigate the role of anatomical changes on patient symptoms and functional disability. We compared the radiological findings to the symptoms and function of patients with LSS measured with standardized methods in a prospective study setting.