Trial reportActa neurochirurgica2023
Is the presence of foraminal stenosis associated with outcome in lumbar spinal stenosis patients treated with posterior microsurgical decompression.
Trial report in Acta neurochirurgica, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02007083 (Comparison of Different Surgical Treatments for Lumbar Spinal Stenosis. A Randomized Controlled Trial Comparing the Clinical and Radiological Results Using "Spinous Process Osteotomy", "Bilateral Laminotomy" and "Unilateral Laminotomy With Crossover"), which is not on this map. Cited by 7 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Comparison of Different Surgical Treatments for Lumbar Spinal Stenosis. A Randomized Controlled Trial Comparing the Clinical and Radiological Results Using "Spinous Process Osteotomy", "Bilateral Laminotomy" and "Unilateral Laminotomy With Crossover"
Who cites it
7 citing papers in PubMed.
- Percutaneous Endoscopic Decompression versus Non-Operative Care for Radicular Pain in the Oldest-Old with Lumbar Stenosis: A Target Trial Emulation Focusing on Pain Relief and Deprescribing.Clinical interventions in aging · 2026Trial
- Ordinal Deep Learning for Lumbar Foraminal Stenosis Grading on Sagittal MRI.Journal of imaging · 2026Article
- Impact of "Asymptomatic," Radiographic Foraminal Stenosis on Lumbar Spine Surgery Outcomes: A Systematic Review.Global spine journal · 2026Review
- An Evaluation of Lumbar Foraminal Stenosis Radiologic Grading Systems: A Systematic Review.Spine surgery and related research · 2026Review
- Anatomic parameters for diagnosing congenital cervical stenosis via computed tomography.Surgical and radiologic anatomy : SRA · 2026Article
- LASSO Logistic Regression was Used to Analyze the Risk Factors for Cauda Equina Injury Secondary to Lumbar Spinal Stenosis and to Build a Risk Model.Journal of musculoskeletal & neuronal interactions · 2025Article
- Quantifying Lumbar Foraminal Volumetric Dimensions: Normative Data and Implications for Stenosis-Part 2 of a Comprehensive Series.Medical sciences (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe aim to investigate associations between preoperative radiological findings of lumbar foraminal stenosis with clinical outcomes after posterior microsurgical decompression in patients with predominantly central lumbar spinal stenosis (LSS).
methodsThe study was an additional analysis in the NORDSTEN Spinal Stenosis Trial. In total, 230 men and 207 women (mean age 66.8 (SD 8.3)) were included. All patients underwent an MRI including T1- and T2-weighted sequences. Grade of foraminal stenosis was dichotomized into none to moderate (0-1) and severe (2-3) category using Lee's classification system. The Oswestry Disability Index (ODI), Zurich Claudication Questionnaire (ZCQ), and numeric rating scale (NRS) for back and leg pain were collected at baseline and at 2-year follow-up. Primary outcome was a reduction of 30% or more on the ODI score. Secondary outcomes included the mean improvement on the ODI, ZCQ, and NRS scores. We performed multivariable regression analyses with the radiological variates foraminal stenosis, Pfirrmann grade, Schizas score, dural sac cross-sectional area, and the possible plausible confounders: patients' gender, age, smoking status, and BMI.
resultsThe cohort of 437 patients presented a high degree of degenerative changes at baseline. Of 414 patients with adequate imaging of potential foraminal stenosis, 402 were labeled in the none to moderate category and 12 in the severe category. Of the patients with none to moderate foraminal stenosis, 71% achieved at least 30% improvement in ODI. Among the patients with severe foraminal stenosis, 36% achieved at least 30% improvement in ODI. A significant association between severe foraminal stenosis and less chance of reaching the target of 30% improvement in the ODI score after surgery was detected: OR 0.22 (95% CI 0.06, 0.83), p=0.03. When investigating outcome as continuous variables, a similar association between severe foraminal stenosis and less improved ODI with a mean difference of 9.28 points (95%CI 0.47, 18.09; p=0.04) was found. Significant association between severe foraminal stenosis and less improved NRS pain in the lumbar region was also detected with a mean difference of 1.89 (95% CI 0.30, 3.49; p=0.02). No significant association was suggested between severe foraminal stenosis and ZCQ or NRS leg pain.
conclusionIn patients operated with posterior microsurgical decompression for LSS, a preoperative severe lumbar foraminal stenosis was associated with higher proportion of patients with less than 30% improvement in ODI.
trial registrationThe study is registered at ClinicalTrials.gov (22.11.2013) under the identifier NCT02007083.
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