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. 2022 Apr;12(3):392-398.
doi: 10.1177/2192568220975378. Epub 2020 Dec 17.

Redundant Nerve Roots of the Cauda Equina, MRI Findings and Postoperative Clinical Outcome: Emphasizing an Overlooked Entity

Liqa A Rousan  1 , Mamoon H Al-Omari  1 , Rasha M Musleh  1 , Mohammad I Amir  1 , Hajar El Kortbi  1 , Nour Abdo  2
Affiliations

Redundant Nerve Roots of the Cauda Equina, MRI Findings and Postoperative Clinical Outcome: Emphasizing an Overlooked Entity

Liqa A Rousan et al. Global Spine J. 2022 Apr.

Abstract

Study design: Retrospective study.

Objective: To describe the MRI findings of RNRs in patients with low back pain, and observe the imaging findings and the clinical outcome post decompression surgery.

Methods: The lumbar spine MRI of 202 patients (122 females) with proven RNRs were retrospectively reviewed. The morphology and the location of the RNRs in relation to the level of stenosis were described. The level(s), grade and cause of lumbar canal stenosis were recorded. The persistence of symptoms and the imaging findings on follow up post decompression surgery were recorded. The imaging findings were correlated among each other and with patients' demographics.

Results: Two distinctive morphological appearance of the RNRs were noted: loop (56.4%), and serpentine-shaped. In the majority of the cases the RNRs were located above the level of stenosis (79.7%). Eighteen patients underwent decompression surgery, only 4 patients remained symptomatic post decompression surgery. The RNRs changed in shape and location after decompression surgery. Age was a strong predictor value in the location of the RNRs. There was no correlation between the shape and location of the RNRs, or with the gender of the patients.

Conclusion: RNRs is not an uncommon finding on lumbar spine MRI with lumbar canal stenosis. Its importance remains a controversy. A common language between the radiologists and the clinicians is mandatory to aid in the management planning.

Keywords: MRI; degenerative disc disease; lumbar; radiology; stenosis.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Morphological configuration of the RNRs demonstrated on sagittal T2 images. (a) Loop-shaped RNRs above L3 level in a patient with moderate spinal canal stenosis at L3-L4 level. (b) Serpentine-shaped RNRs above L3 level in a patient with severe spinal canal stenosis at L3-L4 level.
Figure 2.
Figure 2.
Locations of the RNRs in relation to the focal spinal canal stenosis. (a) Above the level of moderate spinal canal stenosis at L3-L4 level (arrow). (b) Below the level of severe spinal canal stenosis at L3-L4 level. (c) Above and below the level of severe spinal canal stenosis at L3-L4.
See this image and copyright information in PMC

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