332 - Association of Electrodiagnostic positivity and severity of Lumbar Central/Neuroforaminal Stenosis

Objectives: Lumbar central canal spinal stenosis (LSS) and neuroforaminal stenosis (LNS) are common diagnoses in patients with low back pain. These conditions can lead to low back pain with associated neurogenic claudication. Magnetic resonance imaging (MRI) and electrodiagnostic testing (EDX) are routinely used for evaluation purposes. The severity of Lumbar Central canal and Neuroforaminal stenosis has not been researched with reference to associated positivity on EDX. Our study investigates if a link exists between EDX and the degree of LSS/LNS.

Design: Retrospective cohort study on patients with EDX and lumbar MRI.
Data analyzed using statistical tests, including Chi-Square and logistic regression.

Results: Our study found no statistically significant associations between EDX-confirmed radiculopathy and the presence or severity of LSS (p = 0.50 and p = 0.54, respectively) or LNS (p = 0.69 and p = 0.11, respectively). Multivariable logistic regression also showed no statistical significance.
MRI findings were not reliable predictors of EDX results.

Conclusions: To our knowledge the degree of LSS/LNS and associated findings on EDX has not been evaluated prior to this study. The natural history of LSS with moderate symptom levels rarely shows symptom deterioration over a median of 3.3 years. Moreover, it has been found that the probability of spontaneous activity on EDX is also not related to symptom duration. This is unlike the evolution of findings associated with acute nerve pathology, and emergence of neural changes apparent on EDX 3-6 weeks after insult. MRI and EDX can place additional burdens on the healthcare system, costs on patients and ultimately may not have clinical significance. Clinically, most patients with LSS/LNS will improve with conservative treatments including physical therapy, medications NSAIDs and minimally invasive spinal interventions.