Xiandi Wang1, Hongli Wang1, Chi Sun1, Shuyi Zhou2, Tao Meng3, Feizhou Lv1, Xiaosheng Ma1, Xinlei Xia1, Jianyuan Jiang4. 1. Department of Orthopedic Surgery, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 210000, People's Republic of China. 2. Department of Radiology, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 210000, People's Republic of China. 3. Department of MRI Application, Siemens Healthcare Ltd, Shang, No. 278, Zhouzhu Road, Shanghai, 210031, People's Republic of China. 4. Department of Orthopedic Surgery, Huashan Hospital, Fudan University, No. 12 Middle Urumqi Road, Shanghai, 210000, People's Republic of China. jjy@fudanspine.com.
Abstract
PURPOSE: Previous studies have indicated that decreased fractional anisotropy (FA) values on diffusion tensor imaging (DTI) are well correlated with the symptoms of nerve root compression. The aim of our study is to determine primary radiological parameters associated with decreased FA values in patients with lumbar spinal stenosis involving single L5 nerve root. METHODS: Patients confirmed with single L5 nerve root compression by transforaminal nerve root blocks were included in this study. FA values of L5 nerve roots on both symptomatic and asymptomatic side were obtained. Conventional radiological parameters, such as disc height, degenerative scoliosis, dural sac cross-sectional area (DSCSA), foraminal height (FH), hypertrophic facet joint degeneration (HFJD), sagittal rotation (SR), sedimentation sign, sagittal translation and traction spur were measured. Correlation and regression analyses were performed between the radiological parameters and FA values of the symptomatic L5 nerve roots. A predictive regression equation was established. RESULTS: Twenty-one patients were included in this study. FA values were significantly lower at the symptomatic side comparing to the asymptomatic side (0.263 ± 0.069 vs. 0.334 ± 0.080, P = 0.038). DSCSA, FH, HFJD, and SR were significantly correlated with the decreased FA values, with r = 0.518, 0.443, 0.472 and - 0.910, respectively (P < 0.05). DSCSA and SR were found to be the primary radiological parameters related to the decreased FA values, and the regression equation is FA = - 0.012 × SR + 0.002 × DSCSA. CONCLUSIONS: DSCSA and SR were primary contributors to decreased FA values in LSS patients involving single L5 nerve root, indicating that central canal decompression and segmental stability should be the first considerations in preoperative planning of these patients. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: Previous studies have indicated that decreased fractional anisotropy (FA) values on diffusion tensor imaging (DTI) are well correlated with the symptoms of nerve root compression. The aim of our study is to determine primary radiological parameters associated with decreased FA values in patients with lumbar spinal stenosis involving single L5 nerve root. METHODS:Patients confirmed with single L5 nerve root compression by transforaminal nerve root blocks were included in this study. FA values of L5 nerve roots on both symptomatic and asymptomatic side were obtained. Conventional radiological parameters, such as disc height, degenerative scoliosis, dural sac cross-sectional area (DSCSA), foraminal height (FH), hypertrophic facet joint degeneration (HFJD), sagittal rotation (SR), sedimentation sign, sagittal translation and traction spur were measured. Correlation and regression analyses were performed between the radiological parameters and FA values of the symptomatic L5 nerve roots. A predictive regression equation was established. RESULTS: Twenty-one patients were included in this study. FA values were significantly lower at the symptomatic side comparing to the asymptomatic side (0.263 ± 0.069 vs. 0.334 ± 0.080, P = 0.038). DSCSA, FH, HFJD, and SR were significantly correlated with the decreased FA values, with r = 0.518, 0.443, 0.472 and - 0.910, respectively (P < 0.05). DSCSA and SR were found to be the primary radiological parameters related to the decreased FA values, and the regression equation is FA = - 0.012 × SR + 0.002 × DSCSA. CONCLUSIONS: DSCSA and SR were primary contributors to decreased FA values in LSS patients involving single L5 nerve root, indicating that central canal decompression and segmental stability should be the first considerations in preoperative planning of these patients. These slides can be retrieved under Electronic Supplementary Material.
Authors: Roman Guggenberger; Patrick Eppenberger; Daniel Markovic; Daniel Nanz; Avneesh Chhabra; Klaas P Pruessmann; Gustav Andreisek Journal: Eur J Radiol Date: 2012-04-20 Impact factor: 3.528
Authors: Thomas Barz; Markus Melloh; Lukas P Staub; Sarah J Lord; Jörn Lange; Christoph P Röder; Jean-Claude Theis; Harry R Merk Journal: Spine (Phila Pa 1976) Date: 2010-04-15 Impact factor: 3.468
Authors: Leonid Kalichman; Robert Cole; David H Kim; Ling Li; Pradeep Suri; Ali Guermazi; David J Hunter Journal: Spine J Date: 2009-04-23 Impact factor: 4.166