Transverse Posterior Canal Stenosis as a Predictor of Redundant Nerve Roots in Lumbar Stenosis.

IF 2.1 4区 医学 Q3 CLINICAL NEUROLOGY
Dong Li, Dawei Wang, Bingcheng Liu, Tengfei Song, Wei Liu, Hao Tang, Shu Liu, Tianwen Ye
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Abstract

Objectives: Redundant nerve roots (RNR) of the lumbar cauda equina is an important imaging presentation associated with lumbar spinal stenosis (LSS) and considered a potentially powerful prognostic indicator of poor functional recovery after surgery for symptomatic LSS. However, factors contributing to RNR remain undefined. This study aimed to investigate the effects of sagittal and transverse stenosis of the lumbar spinal canal on RNR formation.

Methods: A retrospective case-control study was conducted in 124 LSS patients over 18 years of age. They were divided into a RNR group and a non-RNR group. Correlations of LSS imaging parameters and pathogenic factors with RNR formation were analyzed.

Results: Excluding 16 cases of non-degenerative LSS, 108 patients were finally included for analysis, including 33 patients (30.6%) in RNR group and 75 patients in non-RNR group. Age, included angle of the ligamentum flavum, maximum thickness of the ligamentum flavum, area of the dural sac, total area of the bilateral facet joints, and transverse diameter of the posterior spinal canal (PSC) showed statistically significant differences between the two groups (p≤0.001). The optimal cut-off point for the transverse diameter of PSC was 9.94mm. There was a significant positive correlation of transverse diameter of PSC and area of the dural sac with the presence of RNR (r=0.5897, p<0.001).

Conclusions: Transverse stenosis of PSC is the key factor contributing to RNR formation in LSS patients and the value < 10mm can be used to predict the risk of RNR formation in LSS patients.

后横椎管狭窄作为腰椎管狭窄的神经根冗余的预测因子。
目的:腰椎马尾神经根冗余(RNR)是腰椎管狭窄症(LSS)的重要影像学表现,被认为是症状性LSS术后功能恢复不良的潜在有力预后指标。然而,影响RNR的因素仍不明确。本研究旨在探讨腰椎管矢状和横向狭窄对RNR形成的影响。方法:对124例18岁以上LSS患者进行回顾性病例对照研究。他们被分为RNR组和非RNR组。分析LSS影像学参数及致病因素与RNR形成的相关性。结果:排除16例非退行性LSS,最终纳入108例患者进行分析,其中RNR组33例(30.6%),非RNR组75例。两组患者年龄、黄韧带夹角、黄韧带最大厚度、硬膜囊面积、双侧小关节总面积、后椎管横径(PSC)差异均有统计学意义(p≤0.001)。PSC横向直径的最佳截断点为9.94mm。PSC横径、硬膜囊面积与RNR存在显著正相关(r=0.5897, p)结论:PSC横径狭窄是LSS患者RNR形成的关键因素,其值< 10mm可用于预测LSS患者RNR形成的风险。
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来源期刊
World neurosurgery
World neurosurgery CLINICAL NEUROLOGY-SURGERY
CiteScore
3.90
自引率
15.00%
发文量
1765
审稿时长
47 days
期刊介绍: World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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