Diagnostic performance of the nerve root sedimentation sign in lumbar spinal stenosis: a systematic review and meta-analysis

Wang, Guangye; Peng, Zhan; Li, Jin; Song, Zukun; Wang, Pu

doi:10.1007/s00234-019-02248-3

Cited by 10 publications

(4 citation statements)

References 24 publications

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“…The prevalence rates of relative and absolute stenoses increase with age, reaching 47.2% and 19.4%, respectively, in the 60-to-69-year-old group [ 1 ]. The typical symptoms of LSS are intermittent claudication, back and leg pains, and limb numbness, which lead to severe disability in daily life and negative impacts on quality of life [ 2 , 3 ]. Intervertebral disk dehydration, annular tears, loss of disk height, and degenerative changes of the facet joint and ligamentum flavum (LF) have been determined to contribute to the progression of LSS [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Amelioration of ligamentum flavum hypertrophy using umbilical cord mesenchymal stromal cell-derived extracellular vesicles

Wei

et al. 2023

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Section: Introductionmentioning

confidence: 99%

Amelioration of ligamentum flavum hypertrophy using umbilical cord mesenchymal stromal cell-derived extracellular vesicles

Wei

et al. 2023

Bioactive Materials

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“…In 2010, Barz et al [4] proposed that the NRSS shows high sensitivity and speci city in the diagnosis of lumbar spinal stenosis. Therefore, it can be used as a new imaging index to assist the diagnosis of lumbar spinal stenosis [5][6][7]. Patients with a positive NRSS suffer from poorer clinical outcomes than those with a negative NRSS when they are undergoing conservative therapies [8].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Patients Undergoing Lumbar Disc Herniation With Positive Nerve Root Sedimentation Sign: a Retrospective Case-Control Study

Deng

Hua

Liu

et al. 2020

Preprint

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Background: To investigate the efficacy of percutaneous transforaminal endoscopic discectomy (PTED) in the treatment of patients who were diagnosed with lumbar disc herniation (LDH) with positive nerve root sedimentation sign (NRSS).Methods: A total of 86 patients who underwent LDH were recruited and divided into NRSS-positive group (n=49) and NRSS-negative group(n=37). The visual analog scale (VAS), Japanese Orthopaedic Association (JOA), and Oswestry Disability Index (ODI) were used to evaluate the low back pain and functional recovery and were compared between the two groups.Results: There were no significant differences in the demographic parameters between the two groups. The average area of the dural sac compression in the NRSS-positive group was significantly higher than that in the NRSS-negative group. Patients with a positive NRSS showed a better low back pain relief than those with a negative NRSS at 1 week and 1 month after surgery. The JOA and ODI in the NRSS-positive group were better than those in the NRSS-negative group at 3 months and 6 months postoperatively. The apparent efficiency of JOA and the excellent and good rate of ODI in the negative group was lower than that in the positive group at 6 months after surgery. Conclusions: Patients undergoing LDH with a positive NRSS showed better pain relief and functional recovery than those with a negative NRSS. The present study suggested that NRSS might be a valuable sign and associated with better clinical outcomes in patients undergoing LDH with the treatment of PTED.

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“…A study by Barz and colleagues rst reported that sedimentation sign (SedSign) was helpful in the clinical diagnosis of LSS, as a positive SedSign was common in LSS patients [6]. After this original work, a number of studies consistently suggested that SedSign was a powerful tool in the differential diagnosis for LSS [7][8][9]. Such a view, however, was questioned by some researchers that a positive SedSign was merely suggestive of severe LSS [10,11] and the capability of SedSign in differentiating LSS from nonspeci c back pain was limited [12,13,11].…”

Section: Introductionmentioning

confidence: 99%

Gravity Determines the Direction of Nerve Roots Sedimentation in the Lumbar Spinal Canal

Yang¹,

Feng²,

Hong

et al. 2020

Preprint

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Objectives: To investigate the role of gravity in the sedimentation of lumbar spine nerve roots using magnetic resonance (MR) imaging of various body position. Methods: A total of 56 patients suffered from back pain and underwent conventional supine lumbar spine MR imaging were selected from sanmen hospital database. All the patients were called back to our hospital to perform MR imaging in prone position or lateral position. Furthermore, the sedimentation sign (SedSign) was determined based on the suspension of the nerve roots in the dural sac on cross-sectional MR images, and 31 cases were rated as positive and another 25 cases were negative. Results: The mean age of negative SedSign group was significantly younger than that of positive SedSign group (51.7±8.7 vs 68.4±10.5, P<0.05). The constitutions of clinical diagnosis were significantly different between patients with a positive SedSign and those with a negative SedSign (P<0.001). Overall, nerve roots of the vast majority of patients (48/56, 85.7%) subsided to the ventral side of the dural sac on the prone MR images, although that of 8 (14.3%) patients remain stay in the dorsal side of dural sac. Nerve roots of only one patient with negative SedSign did not settle to the ventral dural sac, while this phenomenon occurred in 7 patients in positive SedSign group (4% vs 22.6%, P<0.001). In addition, the nerve roots of all the five patients subsided to the left side of dural sac on lateral position MR images. Conclusions: The nerve roots sedimentation followed the direction of gravity. Positive SedSign, floating of nerve roots in the canal, may be a MR sign of lumbar pathology involved the spinal canal.

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Diagnostic performance of the nerve root sedimentation sign in lumbar spinal stenosis: a systematic review and meta-analysis

Cited by 10 publications

References 24 publications

Amelioration of ligamentum flavum hypertrophy using umbilical cord mesenchymal stromal cell-derived extracellular vesicles

Amelioration of ligamentum flavum hypertrophy using umbilical cord mesenchymal stromal cell-derived extracellular vesicles

Efficacy of Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Patients Undergoing Lumbar Disc Herniation With Positive Nerve Root Sedimentation Sign: a Retrospective Case-Control Study

Gravity Determines the Direction of Nerve Roots Sedimentation in the Lumbar Spinal Canal

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