CLINICAL AND INSTRUMENTAL PARALLELS OF MRI MANIFESTATIONS AND ELECTROPHYSIOLOGICAL CHANGES IN DEGENERATIVE LUMBAR SPINAL STENOSIS

Relevance. Degenerative lumbar spinal stenosis is a common cause of chronic pain and neurogenic intermittent claudication in elderly and senile patients. Clinical manifestations often do not correlate with the degree of spinal canal narrowing as determined by magnetic resonance imaging, requiring the use of comprehensive diagnostic methods, including electrophysiological ones.

Aim: was to conduct a comprehensive analysis of the relationships between magnetic resonance imaging data, electroneuromyography parameters, and the severity of clinical symptoms in patients with degenerative lumbar spinal stenosis.

Materials and Methods. A comprehensive clinical and instrumental study was conducted on 71 patients, aged 60 to 82 years, diagnosed with degenerative lumbar spinal stenosis. Pain was assessed using a visual analog scale, functional status using the Oswestry scale, and dural sac area using magnetic resonance imaging. The electroneuromyography study included an assessment of the H-reflex from the peroneal and tibial nerves. Statistical analysis was performed using the Spearman correlation coefficient.

Results. A moderate negative correlation was found between the dural sac area and the H-reflex latency (r = -0.68, p < 0.05). The relationship between the degree of stenosis and pain intensity according to the Visual Analogue Scale was weak and insignificant (r = 0.32, p > 0.05). The highest correlation was observed between an increase in the H-reflex latency and a deterioration in the functional status according to the Oswestry index (r = -0.81, p < 0.01).

Conclusion. Electrophysiological methods, particularly H-reflex testing, are a highly sensitive tool for objectively assessing the functional state of spinal roots and nerves in degenerative spinal stenosis. Electrophysiological measurements demonstrate a closer correlation with the patient's functional status than neuroimaging data, making them a valuable tool for monitoring and informing treatment decisions.

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