Foraminal Imaging and Symptoms in Single-Level Degenerative Lumbar Stenosis

This retrospective observational study investigated the correlation between foraminal imaging morphology (evaluated by MRI 4-level score and CT Haleem-Botchu classification) and the severity of clinical symptoms in patients with single-level degenerative lumbar spinal stenosis. A total of 120 adult patients treated between January 2024 and December 2025 were included. Patients were categorized into mild, moderate, and severe groups based on their Visual Analog Scale (VAS) scores. The study analyzed the correlation of imaging grades with clinical functional scores (ODI and VAS) and identified independent imaging factors associated with symptom severity. No new treatments or extra hospital visits were involved.

Inclusion Criteria: 1. Clinically and radiologically diagnosed with single-level degenerative lumbar spinal stenosis. 2. Underwent lumbar CT and MRI examinations. 3. Availability of both lumbar CT and MRI examinations of evaluable quality for foraminal morphology assessment (including Haleem-Botchu CT classification and MRI 4-level score). Exclusion Criteria: 1. Multi-level lumbar spinal stenosis. 2. History of previous lumbar decompression, fusion, or internal fixation surgery. 3. Concomitant lumbar spondylolisthesis or degenerative scoliosis. 4. Concomitant spinal tumors, infections, tuberculosis, or fresh fractures. 5. Severe medical diseases, mental disorders, or inability to cooperate. 6. Missing key baseline clinical parameters. 7. Incomplete imaging datasets. 8. Time interval between imaging examination and clinical evaluation \> 1 month. 9. Non-standard MRI scanning protocols. 10. Severe spinal deformity affecting standardized measurement. 11. Concomitant confounding neurological diseases.