Study on the correlation between radiological indicators, seven-grade classification and Oswestry disability index of surgical spinal stenosis

•The min AP/max AP correlated with ODI in patients with lumbar decompression.•The seven-grade classification has a good predictive effect on the choice of treatment and prognosis of patients with specific types of LSS.•Radiological indicators combined with morphological grade may have important clinical value in patients with LSS. The seven-grade classification refers to a morphological grade of lumbar spinal stenosis (LSS), while the postoperative ODI improvement rate in patients with different grade is still unclear. We explored the potential significance of morphological grade in treatment decision making. In addition, we also conducted a relevant assessment of radiological indicators and symptom indexes. A retrospective cohort study performed decompression surgery in 156 LSS patients with claudication. According to the morphological grade, namely A3 (n = 29), A4 (n = 30), B (n = 33), C (n = 36) and D (n = 28), the patients were divided into 5 groups. Two radiological indicators included the largest cross-sectional area difference (CSAD) of the dural sac and the min AP/max AP, and symptom indexes included an Oswestry disability index (ODI). The relevance between the radiological indicators and the symptom indexes was analyzed. In Pearson analysis, min AP/max AP and preoperative ODI, postoperative ODI, and postoperative ODI improvement rate were r = −0.384 (p