Magnetic Resonance Imaging (MRI) Interpretations for Lumbar Spinal Stenosis (LSS)

Magnetic Resonance Imaging(MRI) has become the gold standard of evaluation of lumbar spinal
stenosis (LSS. LSS is defined as the narrowing of the spinal canal. Thus far, there has
been no formal grading system in literature. Physicians, particularly radiologists, in
their interpretations, currently describe the degree of stenosis at each level as normal,
mild, moderate or severe. Unfortunately, there is no consensus on criteria of these
definitions. Treatments and surgical plans are based primarily on this information.
Consequently, the reliability and accuracy of this information is critical in terms of
optimizing outcomes.

In this study 50-100 MRI studies of patients diagnosed with symptomatic lumbar spinal
stenosis will be collected, de-identified, and assigned a study identification number for
tracking purposes. Three "raters" from Upstate and three "rater" from outside the
institution, that have experience reviewing MRI's will be asked to review the MRI's and
classify the LSS at all lumbar levels as normal, mild, moderate or severe in the central
canal, lateral recesses and the neuroforamen. The raters will not have any information
about the patients. The MRI's will then be given a new identification number, and the
patient's self-assessment questionnaires (which are also de-identified and given the study
id number) will be given to the raters, for a second review. The raters will have the
patients gender, age and outcomes scores from Short form 36, Visual Analog Scale, Oswestry
Disability Index and Zurich Claudication Questionnaires. The raters will classify the MRI,
as normal, mild, moderate or severe using the outcomes and information supplied.

The data from both ratings will be compiled and compared to assess the reliability of the
radiologically established anatomical stenosis when compared with the subjects outcome
scores.

This study is for current patients in Upstate Orthopedics office.