Retrospective analysis of clinical, neurological and degenerative changes in patients with single-level cervical spinal stenosis based on the use of the INDI scale

Objective. To evaluate the ability of the Index of Neurological and Degenerative Impairments (INDI) to reliably stratify patients with single-level cervical spinal stenosis depending on treatment tactics, through a retrospective analysis of clinical, neurological, and neuroimaging data.

Material and Methods. A total of 176 patients with single-level cervical spinal stenosis treated in a neurosurgical hospital were screened. Of these, 77 patients were included in the study based on predefined criteria: Group 1 – conservative treatment (n = 22), Group 2 – surgical treatment (n = 41), and Group 3 – patients who received conservative treatment but were discharged without improvement and placed under observation (n = 14). Patients were treated strictly in accordance with the current Russian Clinical Guidelines for Degenerative Spinal Diseases. A statistical analysis of differences between the groups was performed using the INDI scale, and its prognostic significance was assessed. The INDI scale was used retrospectively, and the scale data did not influence treatment decisions.

Results. Group 1 had an average INDI score of 2.58 ± 1.46, Group 2 – 6.30 ± 1.36, and Group 3 – 2.90 ± 0.36. Patients in Group 2 were younger (46.12 ± 10.65 vs. 53.90 ± 10.66 years in Group 1; p < 0.05), had more pronounced paresis (2.92 ± 0.46 vs. 1.63 ± 1.50; p < 0.05) and more severe degenerative changes (p = 0). Discriminant analysis confirmed significant differences between the groups (Wilks’ lambda = 0.279; p = 0), with INDI score and total neurological impairment score being the most discriminating factors (F = 92.78 and 92.47, respectively). The stratification accuracy was 93.5%.

Conclusion. The INDI scale allows for a unified assessment of the severity of neurological disorders and degenerative changes of the spinal motion segment based on neuroimaging data. It demonstrated a good ability to differentiate between groups in a retrospective sample, however, further prospective studies are required to validate the method.

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