Spinal Radiology associated with Redundant Nerve Roots of cauda equina in lumbar spine stenosis
- PMID: 35700549
- DOI: 10.1016/j.jocn.2022.05.026
Spinal Radiology associated with Redundant Nerve Roots of cauda equina in lumbar spine stenosis
Abstract
Objectives: Redundant Nerve Roots (RNR) is a common radiological observation of elongated tortuous appearance of cauda equina nerve roots in sagittal MRI. It is considered a poor prognostic factor, but the associated spinal morphometry remains unfamiliar.
Methods: A retrospective cohort study was conducted at the Aga Khan University Hospital, Pakistan. Patients, aged 18 or above, undergoing decompressive spinal surgery due to degenerative Lumbar Spinal Canal Stenosis (LSCS) in 2015 were included. Patients were divided in groups as per presence of RNR and assessed for spinal morphometric parameters.
Results: Fifty-two patients, aged 57.52 ± 12.08 years, were enrolled in the study. The patients in RNR group were older than those in non-RNR group (p = 0.023). RNR was significantly associated with sedimentation sign (15 vs 11; p = 0.011), as well as L2/L3 (12 vs 9; p = 0.043) and L3/L4 (18 vs 18; p = 0.034) stenosis. Ligamentum flavum hypertrophy at the most stenotic level was more common in the RNR group (20 vs 19; p = 0.006). The only quantitative parameter statistically associated with RNR was lower ligamentous interfacet distance (5.07 ± 1.95 vs 8.07 ± 4.26 mm; p = 0.010). All other parameters did not contribute to the development of RNR in LSCS patients. The multivariate model revealed significant contribution of age, male sex, ligamentous interfacet distance and disc bulge to develop RNR.
Conclusion: Certain spinal morphometric parameters contribute towards RNR formation, which represents higher degree of spinal stenosis. These parameters, along with RNR, should be regularly reported for preoperative consideration of LSCS management.
Keywords: Central canal stenosis; Redundant Nerve Roots; Spinal anatomy; Spinal morphometry; Spinal stenosis.
Copyright © 2022 Elsevier Ltd. All rights reserved.
Similar articles
-
Redundant nerve roots indicate higher degree of stenosis in lumbar spine stenotic patients.Acta Neurol Belg. 2023 Oct;123(5):1781-1787. doi: 10.1007/s13760-022-02040-w. Epub 2022 Aug 7. Acta Neurol Belg. 2023. PMID: 35934759
-
The clinical significance of redundant nerve roots of the cauda equina in lumbar spinal stenosis patients: A systematic literature review and meta-analysis.Clin Neurol Neurosurg. 2018 Nov;174:40-47. doi: 10.1016/j.clineuro.2018.09.001. Epub 2018 Sep 4. Clin Neurol Neurosurg. 2018. PMID: 30205275
-
Patient demographics and MRI-based measurements predict redundant nerve roots in lumbar spinal stenosis: a retrospective database cohort comparison.BMC Musculoskelet Disord. 2018 Dec 22;19(1):452. doi: 10.1186/s12891-018-2364-4. BMC Musculoskelet Disord. 2018. PMID: 30579338 Free PMC article.
-
Post-surgical functional recovery, lumbar lordosis, and range of motion associated with MR-detectable redundant nerve roots in lumbar spinal stenosis.Clin Neurol Neurosurg. 2016 Jan;140:79-84. doi: 10.1016/j.clineuro.2015.11.016. Epub 2015 Nov 24. Clin Neurol Neurosurg. 2016. PMID: 26683896
-
[Diagnosis and treatment of lumbar spinal canal stenosis].J Nippon Med Sch. 2002 Dec;69(6):583-7. doi: 10.1272/jnms.69.583. J Nippon Med Sch. 2002. PMID: 12646992 Review. Japanese.
Cited by
-
Effectiveness of caudal block in patients with spinal stenosis accompanied by redundant nerve root syndrome.J Int Med Res. 2023 Feb;51(2):3000605231153326. doi: 10.1177/03000605231153326. J Int Med Res. 2023. PMID: 36752034 Free PMC article.
-
MRI parameters predict central lumbar spinal stenosis combined with redundant nerve roots: a prospective MRI study.Front Neurol. 2024 May 27;15:1385770. doi: 10.3389/fneur.2024.1385770. eCollection 2024. Front Neurol. 2024. PMID: 38859971 Free PMC article.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous