The Glasgow Lumbar Spinal Stenosis Scale: a predictor of CSF leak in lumbar decompression surgery
EANS Academy. Cearns M. 09/25/19; 275823; EP02053
Mr. Michael Douglas Cearns
Mr. Michael Douglas Cearns

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Abstract
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Background: The Glasgow Lumbar Spinal Stenosis Scale (GLSSS) is a novel, individualised measurement formula for the radiological diagnosis and quantification of lumbar canal stenosis. Here, we present a retrospective case series analysis that assesses the GLSSS as a tool to predict intra-operative CSF leak as a complication of lumbar decompression surgery.
Methods: 12 patients were selected who underwent lumbar decompression under a single consultant neurosurgeon over a 3-year period. They were divided into a group complicated by CSF leak (leak group, n=6) and an uncomplicated group (non-leak group, n=6). Pre-operative T2-weighted MR images were analysed for: 1) the cross-sectional area of the lumbar canal at the most stenotic level, termed S; and 2) the mean of the cross-sectional areas of the two levels adjacent to the level of interest, termed A. All measurements were performed by a single analyst. The GLSSS formula, (A-S)/A x 100 = R, was used to calculate the relative degree of lumbar canal stenosis expressed as an individualised percentage, termed R.
Results: The mean R-value in the leak group was 67%, vs. 48% in the non-leak group. Two-tailed t-test p-value = 0.019.
Conclusions: The R-value, as calculated by the GLSSS, may be useful as a predictor of CSF leak in lumbar decompression surgery. Further studies will be required to validate this tool in larger sample sizes.
Background: The Glasgow Lumbar Spinal Stenosis Scale (GLSSS) is a novel, individualised measurement formula for the radiological diagnosis and quantification of lumbar canal stenosis. Here, we present a retrospective case series analysis that assesses the GLSSS as a tool to predict intra-operative CSF leak as a complication of lumbar decompression surgery.
Methods: 12 patients were selected who underwent lumbar decompression under a single consultant neurosurgeon over a 3-year period. They were divided into a group complicated by CSF leak (leak group, n=6) and an uncomplicated group (non-leak group, n=6). Pre-operative T2-weighted MR images were analysed for: 1) the cross-sectional area of the lumbar canal at the most stenotic level, termed S; and 2) the mean of the cross-sectional areas of the two levels adjacent to the level of interest, termed A. All measurements were performed by a single analyst. The GLSSS formula, (A-S)/A x 100 = R, was used to calculate the relative degree of lumbar canal stenosis expressed as an individualised percentage, termed R.
Results: The mean R-value in the leak group was 67%, vs. 48% in the non-leak group. Two-tailed t-test p-value = 0.019.
Conclusions: The R-value, as calculated by the GLSSS, may be useful as a predictor of CSF leak in lumbar decompression surgery. Further studies will be required to validate this tool in larger sample sizes.
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