79 World Spinal Column Journal, Volume 4 / No: 3 / September 2013 WScJ 4: 79-82, 2013 Surgical Satisfaction and the Correlation Between Grading System on MRI and the Preoperative Symptoms in Patients with Lumbar Central Canal Stenosis Parisa Azimi, Hasan Reza Mohammadi Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran INTRODUCTION L umbar central canal stenosis (LCCS) is one of the main causes of low back pain (4). e term LCCS means a portion of the main spinal canal has narrowed (9). It is defined as obliteration of the anterior CSF space in front of the cauda equina (8). LCCS characteristically reason pressure on nerve, which can cause pain, numbness, weakness, and tingling (9). Magnetic resonance imaging (MRI) is a non-invasive diagnostic tool that has been used for evaluating the spinal canal in patients with LCCS. Recently, Lee and colleagues described a 4-grade (0, 1, 2 and 3) classification of severity of LCCS based on separation degree of the cauda equina on T2-weighted axial images. ey defined grade 0 as no lumbar stenosis without obliteration of anterior CSF space; grade 1 as mild stenosis with separation of all cauda equina; grade 2 as moderate stenosis with some cauda equina aggregated, making it impossible to visually separate them; and grade 3as severe stenosis with none of the cauda equina separated (8). To date, many studies have analyzed the correlation between the dural sac cross-sectional area (DCSA), grading stenosis based on morphology of the dural sac on MRI, and the severity of symptoms in patients with LCCS, but its use is still controversial (3,10). is study was performed in order to evaluate surgical satisfaction and the relates between grading system based on imaging of the cauda equina on MRI (8), and the severity of ABSTRACT AIM: To study the correlation between the grading system and the severity of symptoms in patients with lumbar central canal stenosis (LCCS) and evaluation of surgical satisfaction. MATERIAL and METHODS: e grading of LCCS was determined on MRI. e severity of symptoms was evaluated based on the duration of symptoms, walking distance, VAS of leg pain/numbness, the NCOS and the JOA score. We studied distribution of grades, and the relation between grading system and severity of symptoms. We determined patient satisfaction using standardized measures. RESULTS: Mean age was 61.2 years. 70% were female. All patients were grade 2 (n = 56) or 3 (n = 28). e symptoms were significantly worse in patients with a grade 3. e walking distance in the patients with grade 3 was significantly shorter than those with grade 2. In addition, the VAS of leg numbness in patients with grade 3 was significantly higher than those with grade 2. e JOA and the NCOS scores were significantly lower in patients with grade 3. Post-surgical satisfaction was 90.5%. CONCLUSIONS: e findings show that the patients’ symptoms, walking activity and functionality in grade 2 are better than in grade 3. It seems that grade-3 is satisfied than grade-2 system patients with outcome. KEY WORDS: JOA, lumbar central canal stenosis, MRI, NCOS