Presence of Dural Pulsation in Patients Diagnosed With Lumbar Spinal Stenosis

NCT ID: NCT07233798

Last Updated: 2025-12-09

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Total Enrollment

84 participants

Study Classification

OBSERVATIONAL

Study Start Date

2025-12-07

Study Completion Date

2026-12-30

Brief Summary

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Lumbar spinal stenosis is defined as the narrowing of the spinal canal resulting from degenerative changes in the spinal joints, intervertebral discs, and the ligamentum flavum.

Pressure fluctuations within the cerebral and spinal vascular systems lead to the formation of pulsations. The periodic occurrence of these pulsations in the dura mater is referred to as spinal dural pulsation.The vibratory movements of the dura mater have been interpreted as an indicator that the spinal cord is freely mobile within the subarachnoid space and not subjected to any external compression.This study aims to investigate whether the presence of dural pulsation is associated with clinical and radiological parameters in patients diagnosed with lumbar spinal stenosis

Detailed Description

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Lomber spinal stenosis is defined as a narrowing of the spinal canal resulting from degenerative changes in the spinal joints, intervertebral discs, and the ligamentum flavum. The reduction in the space surrounding the neurovascular structures may lead to significant clinical symptoms such as neurogenic claudication, radiating pain in the lower extremities, low back pain, and urinary or fecal incontinence. Symptoms often improve when patients sit down or lean forward. However, if the pain induced by standing or walking postures becomes severe, it may impair the ability to perform daily and independent activities.

Magnetic Resonance Imaging is the primary imaging modality for the diagnosis of LSS. It provides high sensitivity and specificity in identifying anatomical abnormalities such as disc herniation, facet joint degeneration, and hypertrophy of the ligamentum flavum. However, as MRI findings may be influenced by factors such as patient positioning and imaging protocols, the interpretation of MRI should always be correlated with clinical findings in the diagnosis of LSS.

Periodic oscillations within the central nervous system occur due to pressure changes in the cerebral and spinal vascular systems. The rhythmic occurrence of these oscillations at the level of the dura mater is referred to as spinal dural pulsation. In previous studies, the vibratory movements of the spinal cord, dura mater, and cerebrospinal fluid (CSF) have been observed intraoperatively and evaluated in detail using MRI. Surgeons have interpreted these rhythmic movements of the dura mater as an indication that the spinal cord is freely suspended within the subarachnoid space and not subjected to external compression. This has been considered in earlier studies as a finding correlated with the presence of spinal dural pulsation.In this study, patients will be placed in the prone position, and the presence of dural pulsation will be evaluated using ultrasound.

The aim of this study is to evaluate the relationship between the presence of spinal dural pulsation and the clinical and radiological findings in patients diagnosed with lumbar spinal stenosis.

This study has been approved by the Marmara University Faculty of Medicine Non-Pharmaceutical and Non-Medical Device Clinical Trials Ethics Committee with the ethics approval number 09.2025.25-0459.

Conditions

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Lumbar Spinal Stenosis Numerical Rating Scale Disability Physical Magnetic Resonance Claudication

Study Design

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Observational Model Type

OTHER

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Positive for dural pulsation

No interventions assigned to this group

Negative for dural pulsation

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Aged between 18 and 85 years
* Patients experiencing low back and/or leg pain attributable to lumbar spinal stenosis
* Presence of lumbar spinal stenosis at least at one level consistent with clinical symptoms on lumbar MRI

Exclusion Criteria

* Body Mass Index (BMI) ≥ 35 kg/m²
* Patients with radiculopathy due to lumbar disc herniation
* Patients with axial low back pain caused by facet syndrome, sacroiliac dysfunction, or discogenic pain
* History of lumbar spine surgery
* Individuals with mental retardation
* Patients with major psychiatric comorbidities
* Patients with congenital spinal anomalies
* Inflammatory rheumatic diseases characterized by osteophyte formation and ligament calcification, such as ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis (DISH)
* Pregnancy
* Patients with heart failure
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Marmara University

OTHER

Sponsor Role lead

Responsible Party

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Haner Direskeneli

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Fatma B Akdağ, Research Assistant

Role: PRINCIPAL_INVESTIGATOR

Marmara University Faculty of Medicine ,Marmara University, Department of Physical Medicine and Rehabilitation

Osman H Gündüz, Professor

Role: STUDY_DIRECTOR

Algology Division, Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine

Serdar Kokar, Associate Professor

Role: STUDY_DIRECTOR

Algology Division, Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine

Savaş Şencan, Associate Professor

Role: STUDY_DIRECTOR

Algology Division, Department of Physical Medicine and Rehabilitation, Marmara University Faculty of Medicine

Locations

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Marmara University Faculty of Medicine, Pendik Training and Research Hospital, Algology Department

Pendik, Istanbul, Turkey (Türkiye)

Site Status RECRUITING

Countries

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Turkey (Türkiye)

Central Contacts

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Fatma B Akdağ, Research Assistant

Role: CONTACT

+90 537 452 96 60

Savaş Şencan, Associate Professor

Role: CONTACT

+90 537 066 57 13

Facility Contacts

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Fatma B Akdağ, Research Assistant

Role: primary

+905374529660

Other Identifiers

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MarmaraU-FTR-FBA-01

Identifier Type: -

Identifier Source: org_study_id

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