PONE-D-21-31516A large-scale, population-based cohort study in Japan to determine the effect of lumbar spinal stenosis seen on MRI on the quality of life: The Wakayama Spine StudyPLOS ONE

Dear Dr. Ishimoto,

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PLOS ONE

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Three reviewers have positive opinions on this paper. I also find the topic and aim useful. If you suitably manage the minor revisions, this manuscript would have an essential contribution to the literature. Your revised paper will be sent to the reviewers. Best Regards

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: I Don't Know

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Report on

A large-scale, population-based cohort study in Japan to determine the effect of lumbar spinal stenosis seen on MRI on the quality of life: The Wakayama Spine Study

or

Effect of lumbar spinal stenosis seen on MRI on the quality of life

General Comments:

Lumbar spinal stenosis is a narrowing of the spinal canal in the lower part of the patient's back. The manuscript aimed to aimed to determine the association between radiographic lumbar spinal stenosis (LSS) and the quality of life (QOL) in the general Japanese population.

907 patients were clustered into 4 groups no, mild, moderate, and severe stenosis. The study was prospective which is a very good advantage.

Exclusion Criteria:

1. Patients younger than 40 years.

2. Patients who had undergone previously to lumber spine surgery.

In this general population study, severe radiographic LSS was associated with LBP, but did not affect ODI.

The topic is interesting and is of relevance to the readers of the journal.

Introduction

The introduction was well organized and fully explained.

Methodology

1. Description of the experimental procedures was concise and contained detailed descriptions of well-established procedures.

2. The number of patients was sufficient.

3. Inclusion and Exclusion criteria seem logical.

Results and Discussion

1. The results were represented by nice and informative radiographic images showing LSS.

2. The study findings were adequately discussed.

Decision

The study is interesting. Therefore, I recommend it for publication as it is.

Reviewer #2: Thanks for inviting me to review the manuscript entitled “A large-scale, population-based cohort study in Japan to determine the effect of lumbar spinal stenosis seen on MRI on the quality of life: The Wakayama Spine Study ”. I am glad to have an opportunity to give some comments on this work.

1. In general, I think this is a nice work done by a large group of researchers and doctors, who conducted a quite large-scale study. I fully understand this is not easy and appreciate the hardworking.

2. The title is wordy, so it could be more concise.

3. In abstract, the font size is not consistent. And in methods, logistic regression analysis was not mentioned but in results, it was used in fact.

4. In the Introduction, the words "radiographic LSS and the quality of life (QOL) has not been investigated in the Japanese general population.. Therefore, we aimed to assess the effect of radiographic LSS on the QOL using mobile magnetic resonance imaging (MRI) and the Oswestry Disability Index (ODI) in them" is not scientific, and more importantly, in the discussion part (paragraph 3) described that "there are vary reports on the relationship between radiographic LSS and QOL.."

5. How many cases were excluded and the reason?

6. As this is a large-scale clinical study, some useful clinical relevance in Conclusion would be more attractive.

Reviewer #3: The manuscript titled: A large-scale, population-based cohort study in Japan to determine the effect of lumbar

spinal stenosis seen on MRI on the quality of life: The Wakayama Spine Study is good and interesting.

Some comments were found.

Abstract:

Page 6 Line 91: The prevalence of severe, moderate, and non-mild/non-radiographic ..........This sentence incomplete

Line 100: LBP2: Abbreviation should be written in complete form when mentioned for the first time in the manuscript

Materials and Methods:

Page 11 Line 182-187: Number of patient is incorrect (It should be938 patient). You should explain this.

Fig. 5. The figure should be corrected.

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Reviewer #1: Yes: Amr Abd-Elghany

Reviewer #2: No

Reviewer #3: No

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Attachments

Attachment

Submitted filename: report.docx

Is radiographic lumbar spinal stenosis associated with the quality of life?: The Wakayama Spine Study

PONE-D-21-31516R1

Dear Dr. Ishimoto,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Fatih Özden, PhD

Academic Editor

PLOS ONE

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

Reviewer #3: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: The authors responded to all the reviewers comments. I have no further comments to authors and recommend it to be accepted.

Reviewer #2: The questions are well addressed and there are no further comments. It is time to accept this artwork!

Reviewer #3: The manuscript is interesting and good written and discussed.

Abstract is good written

Introduction is good written

Materaials and results are good written and illustrated

Discussion is good written

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: Yes: Amr Abd-Elghany

Reviewer #2: No

Reviewer #3: No