P.104 The diagnostic value of the nerve root sedimentation sign for symptomatic lumbar stenosis. (June 2019)

• Record Type: Journal Article
• Authors: Huschi, Z; Neuburger, L; Ahmed, U; Cheng, Y; Fourney, DR
• Is Part Of: Canadian journal of neurological sciences. Volume 46(2019)Supplement 1
• Page Start: S41
• Page End: S41
• Publication Date: 2019-06
• Subjects: Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Electronic journals; 616.8
• DOI: 10.1017/cjn.2019.198
• Languages: English
• ISSNs: 0317-1671

Abstract

Abstract : Background: Previous studies have shown varied results with respect to the diagnostic utility of a positive nerve root sedimentation sign (SedSign) on MRI for symptomatic lumbar stenosis. The objective of this study was to analyze the clinical characteristics of SedSign utilizing a validated classification for low back and leg pain (Saskatchewan Spine Pathway classification; SSPc). Methods: This was a retrospective review of prospectively-collected data in 367 consecutive adult patients presenting to a spine surgeon with back and/or leg pain between January 1, 2012 and May 31, 2018. Inter- and intra-rater reliability for SedSign was 73% and 91%, respectively (3 examiners). Results: SedSign was positive in 111 (30.2%) and negative in 256 (69.8%) of patients. On the univariate analysis, a positive SedSign was correlated with age, male sex, several components of ODI, EQ5D mobility, cross-sectional area (CSA) of stenosis, and SSPc pattern 4 (intermitted leg dominant pain). On multivariate analysis, SedSign was associated with age, male sex, CSA stenosis and ODI sub-score for walking distance. The sensitivity and specificity of SedSign for neurogenic claudication was 50.3 and 82.9, respectively (positive predictive value 65.8%, negative predictive value 71.9%). Conclusions: The SedSign has high specificity for neurogenic claudication, but the sensitivity is poor.