Grant: CIHR Fellowship

Lumbar Spinal Stenosis is a condition that is believed to primarily have a degenerative aetiology in which narrowing of the spinal canal results in entrapment and compression of neurovascular structures. The prevalence of spinal stenosis has increased with the aging of the population, yet limited information is available to determine prognosis and guide effective management. Although a narrowing of the spinal canal or neural foramen identified on magnetic resonance imaging (MRI) is a defining feature for the diagnosis of spinal stenosis, it is unclear why the clinical syndrome develops in some, but not others with similar imaging findings. A study with repeated standard MR imaging could provide insight into this variability in patient outcomes. Furthermore, one of the main drawbacks of traditional MRI is that patients are imaged in a neutral spinal position and patients' symptoms are commonly aggravated by direction-specific posturing of the lumbar spine. Therefore, positional MRI could provide new information regarding the stage and severity of the stenosis and provide explanatory or prognostic information for patients outcomes. Thus, the proposed study aims to identify novel prognostic factors, focusing on imaging findings and to gain further insight into the variability in patient outcomes. These aims will be accomplished through acquisition of repeated imaging and positional MRI from patients with lumbar spinal stenosis. We will recruit a subgroup of patients from a prognostic study that followed over 500 patients with spinal stenosis over a 5 year period. Innovative research methods and cutting edge technologies in imagery will be used to gain a better understanding of associated anatomical changes on the site of the spinal stenosis and its role in symptom progression. The new information acquired will inform health care decision-making of affected patients, health care providers and policy makers, and guide the development of more effective interventions.