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Department of Surgery, School of Medicine, University of Zenica , Zenica , Bosnia and Herzegovina
Department of Anatomy, School of Medicine, University of Zenica , Zenica , Bosnia and Herzegovina
Department of Neurosurgery, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina
Department of Neurosurgery, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina
Department of General Medicine, School of Medicine, University of Zenica , Zenica , Bosnia and Herzegovina
Department of Anatomy, School of Medicine, University of Zenica , Zenica , Bosnia and Herzegovina
Department of Anatomy, School of Medicine, University of Banja Luka , Banja Luka , Bosnia and Herzegovina
Department of Anatomy, School of Medicine, University of Banja Luka , Banja Luka , Bosnia and Herzegovina
Department of Gynaecology, Canton Hospital Zenica , Zenica , Bosnia and Herzegovina
Department of Gynaecology, Canton Hospital Zenica , Zenica , Bosnia and Herzegovina
Department of Intensive Care, Internal Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina
Department of Neurosurgery, University Hospital Mostar , Mostar , Bosnia and Herzegovina
Department of General Medicine, School of Medicine, University of Sarajevo , Sarajevo , Bosnia and Herzegovina
Neurosurgery Clinic, University Clinical Centre Sarajevo , Sarajevo , Bosnia and Herzegovina
Department of Neurosurgery, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina
Department of Physiology, School of Medical Sciences, University of Kragujevac , Kragujevac , Serbia
Department of Anaesthesiology, Clinical Hospital Zvezdara , Belgrade , Serbia
Aim To investigate clinical and morphometric characteristics of patients with lower urinary tract symptoms (LUTS) due to lumbar spinal stenosis (LSS).
Methods This study evaluated LSS patients using clinical assessments of motor, sensory, bladder, and bowel functions, and functional disability scores from the Oswestry Disability Index (ODI) and Swiss Spinal Stenosis Questionnaire (SSSQ). Morphometric analysis included MRI measurements of the anteroposterior diameter of the intervertebral disc and dural sac, and the modified Torg-Pavlov ratio (mTPR), with follow-up re-evaluations at 6 months.
Results Of 159 patients, 49 (30.8%) had LUTS and 110 (69.2%) were in the control group. LUTS patients had a significantly higher prevalence of neurogenic claudication (100% vs. 47.3%; p<0.001), lower back pain (93.9% vs. 77.3%; p=0.011), and lower extremity pain (57.1% vs. 34.5%; p=0.008). The LUTS group also had higher ODI (54.0 vs. 50.0; p=0.019) and SSSQ score (44.0 vs. 34.0; p<0.001). Morphometric analysis showed significantly lower mTPR in LUTS patients (median 0.31 vs. 0.45; p<0.001), with an AUC of 0.704 (95%CI 0.627-0.774). mTPR≤0.31 predicted surgical revision within 6 months (OR:3.4, CI: 1.2-9.8), motor deficiency (OR:2.1, 95%CI: 1.4-5.2), and persistent LUTS post-surgery (OR:4.5, 95%CI: 1.1-18.9). mTPR≤0.34 was associated with worse follow-up outcome, including increased ODI (β:3.2; 95%CI: 1.1-5.3; p=0.004) and SSSQ score (β:4.8; 95%CI:2.1-7.5).
Conclusion LUTS patients with LSS exhibit more severe symptoms and poorer outcome, with mTPR≤0.34 being a predictor of adverse clinical outcome and the need for surgical revision within 6 months.
Conceptualization, H.H., H.B. and E.B.; Investigation, H.H., E.B., G.L. and A.N.; Writing – original draft, H.H., G.L., H.S. and A.J.; Writing – review & editing, H.H., H.B., E.B. and J.R.; Methodology, H.B., E.B. and N.H.; Resources, H.B., R.I. and T.Z.; Supervision, H.B., E.B. and H.S.; Data curation, E.B.; Software, E.B.; Visualization, E.B.; Validation, I.S., A.P. and R.I.; Formal Analysis, T.Z. and E.B.; Project administration, E.B. All authors have read and agreed to the published version of the manuscript.
No specific funding was received for this study
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