Introduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution MR imaging

Abstract In this paper we sought to develop and assess the reproducibility of an updated 6-point grading system for lumbar foraminal stenosis based on the widely used Lee classification that more accurately describes lumbar foraminal stenosis as seen on high-resolution MRI. Grade A indicates absence...

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Autores principales:	Elisabeth Sartoretti, Michael Wyss, Alex Alfieri, Christoph A. Binkert, Cyril Erne, Sabine Sartoretti-Schefer, Thomas Sartoretti
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/824903280d804c4a962e5fecfc10e2b2
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spelling	oai:doaj.org-article:824903280d804c4a962e5fecfc10e2b22021-12-02T14:58:20ZIntroduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution MR imaging10.1038/s41598-021-91462-22045-2322https://doaj.org/article/824903280d804c4a962e5fecfc10e2b22021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91462-2https://doaj.org/toc/2045-2322Abstract In this paper we sought to develop and assess the reproducibility of an updated 6-point grading system for lumbar foraminal stenosis based on the widely used Lee classification that more accurately describes lumbar foraminal stenosis as seen on high-resolution MRI. Grade A indicates absence of foraminal stenosis. Grades B, C, D and E indicate presence of foraminal stenosis with contact of the nerve root with surrounding anatomical structures (on one, two, three or four sides for B, C, D and E respectively) yet without morphological change of the nerve root. To each grade, a number code indicating the location of contact between the nerve root and surrounding anatomical structure(s) is appended. 1, 2, 3 and 4 indicate contact of the nerve root at superior, posterior, inferior and anterior position of the borders of the lumbar foramen. Grade F indicates presence of foraminal stenosis with morphological change of the nerve root. Three readers graded the lumbar foramina of 101 consecutive patients using high-resolution T2w (and T1w) MR images with a spatial resolution of beyond 0.5 mm3. Interreader agreement was excellent (Cohen’s Kappa = 0.866–1). Importantly, 30.6%/31.6%/32.2% (reader 1/reader 2/ reader 3) of foramina were assigned grades that did not appear in the original Lee grading system (grades B and D). The readers found no foramen that could not be described accurately with the updated grading system. Thus, an updated 6-point grading system for lumbar foraminal stenosis is reproducible and comprehensively describes lumbar foraminal stenosis as seen on high-resolution MRI.Elisabeth SartorettiMichael WyssAlex AlfieriChristoph A. BinkertCyril ErneSabine Sartoretti-ScheferThomas SartorettiNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Elisabeth Sartoretti Michael Wyss Alex Alfieri Christoph A. Binkert Cyril Erne Sabine Sartoretti-Schefer Thomas Sartoretti Introduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution MR imaging
description	Abstract In this paper we sought to develop and assess the reproducibility of an updated 6-point grading system for lumbar foraminal stenosis based on the widely used Lee classification that more accurately describes lumbar foraminal stenosis as seen on high-resolution MRI. Grade A indicates absence of foraminal stenosis. Grades B, C, D and E indicate presence of foraminal stenosis with contact of the nerve root with surrounding anatomical structures (on one, two, three or four sides for B, C, D and E respectively) yet without morphological change of the nerve root. To each grade, a number code indicating the location of contact between the nerve root and surrounding anatomical structure(s) is appended. 1, 2, 3 and 4 indicate contact of the nerve root at superior, posterior, inferior and anterior position of the borders of the lumbar foramen. Grade F indicates presence of foraminal stenosis with morphological change of the nerve root. Three readers graded the lumbar foramina of 101 consecutive patients using high-resolution T2w (and T1w) MR images with a spatial resolution of beyond 0.5 mm3. Interreader agreement was excellent (Cohen’s Kappa = 0.866–1). Importantly, 30.6%/31.6%/32.2% (reader 1/reader 2/ reader 3) of foramina were assigned grades that did not appear in the original Lee grading system (grades B and D). The readers found no foramen that could not be described accurately with the updated grading system. Thus, an updated 6-point grading system for lumbar foraminal stenosis is reproducible and comprehensively describes lumbar foraminal stenosis as seen on high-resolution MRI.
format	article
author	Elisabeth Sartoretti Michael Wyss Alex Alfieri Christoph A. Binkert Cyril Erne Sabine Sartoretti-Schefer Thomas Sartoretti
author_facet	Elisabeth Sartoretti Michael Wyss Alex Alfieri Christoph A. Binkert Cyril Erne Sabine Sartoretti-Schefer Thomas Sartoretti
author_sort	Elisabeth Sartoretti
title	Introduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution MR imaging
title_short	Introduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution MR imaging
title_full	Introduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution MR imaging
title_fullStr	Introduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution MR imaging
title_full_unstemmed	Introduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution MR imaging
title_sort	introduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution mr imaging
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/824903280d804c4a962e5fecfc10e2b2
work_keys_str_mv	AT elisabethsartoretti introductionandreproducibilityofanupdatedpracticalgradingsystemforlumbarforaminalstenosisbasedonhighresolutionmrimaging AT michaelwyss introductionandreproducibilityofanupdatedpracticalgradingsystemforlumbarforaminalstenosisbasedonhighresolutionmrimaging AT alexalfieri introductionandreproducibilityofanupdatedpracticalgradingsystemforlumbarforaminalstenosisbasedonhighresolutionmrimaging AT christophabinkert introductionandreproducibilityofanupdatedpracticalgradingsystemforlumbarforaminalstenosisbasedonhighresolutionmrimaging AT cyrilerne introductionandreproducibilityofanupdatedpracticalgradingsystemforlumbarforaminalstenosisbasedonhighresolutionmrimaging AT sabinesartorettischefer introductionandreproducibilityofanupdatedpracticalgradingsystemforlumbarforaminalstenosisbasedonhighresolutionmrimaging AT thomassartoretti introductionandreproducibilityofanupdatedpracticalgradingsystemforlumbarforaminalstenosisbasedonhighresolutionmrimaging
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Introduction and reproducibility of an updated practical grading system for lumbar foraminal stenosis based on high-resolution MR imaging

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