J Korean Soc Radiol.  2022 Jan;83(1):102-111. 10.3348/jksr.2021.0017.

To Assess Whether Lee’s Grading System for Central Lumbar Spinal Stenosis Can Be Used as a Decision-Making Tool for Surgical Treatment

• Ahn DY
• Park HJ
• Yi JW
• Kim JN

• KMID: 2525176
• DOI: http://doi.org/10.3348/jksr.2021.0017

Abstract

Purpose
To evaluate the correlation between Lee’s grades and surgical intervention for central lumbar spinal stenosis (CLSS) and to assess whether this grading system can be used as a decision-making tool for the surgical treatment of this condition.
Materials and Methods
This retrospective study included 290 patients (M:F = 156:134; mean age, 46 ± 16 years). Radiologists assessed the presence and grade of CLSS at the stenosis point according to Lee’s grading system, in which CLSS is classified into four grades according to the shape of the cauda equina. Correlation coefficients (r_s) between Lee’s grades and the operation were calculated with Spearman rank correlation.
Results
Among the operated patients, grade 2 was the most commonly assigned grade (50%– 58%), grade 3 was less common (35%), and grade 0 was the least common (2%–3%). Among the non-operated patients, grade 1 was the most common (63%–65%), grade 0 was less common (15%–16%), and grade 3 was the least common (8%). The distribution of grades differed between the operated and non-operated groups (p < 0.001). Less than 25% of patients who underwent surgery were assigned grades 0 and 1, and more than 88% were assigned grades 2 and 3. A moderate correlation was found between the grade and surgical intervention (r_s = 0.632 and r_s = 0.583).
Conclusion
Lee’s grade was moderately correlated with surgical intervention. Lee’s grading system can be a decision-making tool for the surgical treatment of CLSS.

Keyword

Magnetic Resonance; Lumbar Vertebrae; Surgery; Spinal Stenosis; Spinal Canal