Lumbar Spinal Nerve Lateral Entrapment

Kirkaldy-Willis, W. H.; Wedge, John H.; Yong-Hing, K; Tchang, S; Korompay, V de; Shannon, R S

doi:10.1097/00003086-198209000-00026

Cited by 74 publications

(27 citation statements)

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“…limited lumbar extension to the painful side (Kemp sign) were observed at high frequency. 23 Although imaging studies including radiography, CT, and MR imaging [26][27][28][29] provide an effective means for evaluating foraminal stenosis, these conventional imaging techniques do not detect foraminal stenosis with any certainty because false-positive findings may be frequently observed. Evaluation of clinical findings and selective nerve root infiltration and block are necessary to make a correct diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Quantitative Evaluation and Visualization of Lumbar Foraminal Nerve Root Entrapment by Using Diffusion Tensor Imaging: Preliminary Results

Eguchi¹,

Ohtori²,

Orita³

et al. 2011

AJNR Am J Neuroradiol

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Section: Discussionmentioning

confidence: 99%

Quantitative Evaluation and Visualization of Lumbar Foraminal Nerve Root Entrapment by Using Diffusion Tensor Imaging: Preliminary Results

Eguchi¹,

Ohtori²,

Orita³

et al. 2011

AJNR Am J Neuroradiol

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“…In its clinical presentation, severe leg pain at rest and limited lumbar extension to the painful side (Kemp's sign) were observed at high frequency [27]. Although imaging studies including radiography, CT, and MRI [30][31][32][33] provide an effective means for evaluating the foraminal stenosis, these conventional imaging techniques do not detect foraminal stenosis with any certainty because falsepositive findings may be frequently observed. Evaluation of clinical findings and selective nerve root infiltration and block are necessary to make a correct diagnosis [34].…”

Section: Discussionmentioning

confidence: 99%

Clinical applications of diffusion magnetic resonance imaging of the lumbar foraminal nerve root entrapment

et al. 2010

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Diffusion-weighted imaging (DWI) can provide valuable structural information about tissues that may be useful for clinical applications in evaluating lumbar foraminal nerve root entrapment. Our purpose was to visualize the lumbar nerve root and to analyze its morphology, and to measure its apparent diffusion coefficient (ADC) in healthy volunteers and patients with lumbar foraminal stenosis using 1.5-T magnetic resonance imaging. Fourteen patients with lumbar foraminal stenosis and 14 healthy volunteers were studied. Regions of interest were placed at the fourth and fifth lumbar root at dorsal root ganglia and distal spinal nerves (at L4 and L5) and the first sacral root and distal spinal nerve (S1) on DWI to quantify mean ADC values. The anatomic parameters of the spinal nerve roots can also be determined by neurography. In patients, mean ADC values were significantly higher in entrapped roots and distal spinal nerve than in intact ones. Neurography also showed abnormalities such as nerve indentation, swelling and running transversely in their course through the foramen. In all patients, leg pain was ameliorated after selective decompression (n = 9) or nerve block (n = 5). We demonstrated the first use of DWI and neurography of human lumbar nerves to visualize and quantitatively evaluate lumbar nerve entrapment with foraminal stenosis. We believe that DWI is a potential tool for diagnosis of lumbar nerve entrapment.

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“…Macnab et al 59) appropriately named lumbar foraminal stenosis the "hidden zone," as it is often overlooked, it accounts for approximately 60% of failed back surgery syndromes, and it decreases surgical success rates 60) . Diagnostic imaging of lumbar spinal canal stenosis includes X-rays, CT, and MRI [61][62][63] , along with functional diagnosis via selective nerve root imaging and infiltration 64) . Conventional MRI has a false positive rate of 30% to 40% .…”

Section: Diagnosis Of Lumbar Foraminal Stenosis With Dtimentioning

confidence: 99%

Recent advances in magnetic resonance neuroimaging of lumbar nerve to clinical applications: A review of clinical studies utilizing Dffusion Tensor Imaging and Diffusion-weighted magnetic resonance neurography

Eguchi

Kanamoto

Oikawa³

et al. 2017

Spine Surg Relat Res

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Abstract:Much progress has been made in neuroimaging with Magnetic Resonance neurography and Diffusion Tensor Imaging (DTI) owing to higher magnetic fields and improvements in pulse sequence technology. Reports on lumbar nerve DTI have also increased considerably.Many studies have shown that the use of DTI in lumbar nerve lesions, such as lumbar foraminal stenosis and lumbar disc herniation, makes it possible to capture images of interruptions of tractography at stenotic sties, enabling the diagnosis of stenosis. DTI can also reveal significant decreases in fractional anisotropy (FA) with significant increases in apparent diffusion coefficient (ADC) values in compression lesions.FA values have higher accuracy than ADC values. Furthermore, strong correlations exist between FA values and indications of neurological severity, including the Japanese Orthopedic Association (JOA) score, the Oswestry Disability Index (ODI), and the Roland-Morris Disability Questionnaire (RDQ) in patients with lumbar disc herniation-induced radiculopathy.Most lumbar DTI has become 3T; 3T MRI has made it possible to take high-resolution DTI measurements in a short period of time. However, increased motion artifacts in the magnetic susceptibility effect lead to signal irregularities and image distortion. In the future, high-resolution DTI with reduced field-of-view may become useful in clinical applications, since visualization of nerve lesions and quantification of DTI parameters could allow more accurate diagnoses of lumbar nerve dysfunctions. Future translational studies will be necessary to successfully bring MR neuroimaging of lumbar nerve into clinical use.

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Lumbar Spinal Nerve Lateral Entrapment

Cited by 74 publications

References 0 publications

Quantitative Evaluation and Visualization of Lumbar Foraminal Nerve Root Entrapment by Using Diffusion Tensor Imaging: Preliminary Results

Quantitative Evaluation and Visualization of Lumbar Foraminal Nerve Root Entrapment by Using Diffusion Tensor Imaging: Preliminary Results

Clinical applications of diffusion magnetic resonance imaging of the lumbar foraminal nerve root entrapment

Recent advances in magnetic resonance neuroimaging of lumbar nerve to clinical applications: A review of clinical studies utilizing Dffusion Tensor Imaging and Diffusion-weighted magnetic resonance neurography

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