Microstructural changes are coincident with the improvement of clinical symptoms in surgically treated compressed nerve roots

Abstract

Diffusion tensor imaging (DTI) has been widely used to visualize peripheral nerves, but the microstructure of compressed nerve roots can be assessed using DTI. However, there are no data regarding the association among microstructural changes evaluated using DTI, the symptoms assessed using the Oswestry Disability Index (ODI) and the duration of symptoms after surgery in patients with lumbar disc herniation (LDH). Thirty patients with unilateral radiculopathy were investigated using DTI. The changes in the mean fractional anisotropy (FA) and the apparent diffusion coefficient (ADC) values as well as the correlation between these changes and the severity and duration of the clinical symptoms were investigated before and at least one month after surgery. The FA values were significantly increased after surgical treatment (p < 0.0001). Both the ADC and ODI values were noticeably decreased (p < 0.0001). A strong positive correlation between the preoperative and postoperative DTI parameters (p < 0.0001) as well as between the preoperative ODI and postoperative ODI/ODI changes (p < 0.0001) were found. In addition, there was a significant positive correlation between the changes in the DTI parameters and changes in the ODI (p < 0.0001). This preliminary study suggests it may be possible to use DTI to diagnose, quantitatively evaluate and follow-up patients with LDH.

Utility of diffusion tensor imaging for guiding the treatment of lumbar disc herniation by percutaneous transforaminal endoscopic discectomy

“…The sensitivity and specificity of FA values for the detection of nerve injury have been reported to be higher than those of ADC values (73.3% and 100% vs. 13.4% and 80%). FA values appear to be superior to ADC values in the diagnosis of lumbosacral radiculopathy, with potential application for post-treatment evaluation 2,16–19 . Therefore, in this study, we used FA values for preoperative diagnosis, postoperative evaluation and prognosis of patients with LDH.…”

“…Indeed, DTI is widely used in the clinical evaluation of nerve root lesions. Although research has shown a significant negative correlation between the FA value of compressed nerve roots and ODI scores 2 , few studies have evaluated the relationship between the dynamic changes of postoperative DTI indicators and the improvement of clinical symptoms. Therefore, all the patients in this study underwent PTED, and DTI scanning was performed before surgery, as well as 3 days, 1 month, and 3 months post-surgery, respectively.…”

“…However, in clinical practice, the degree of nerve root compression observed in MRI is often inconsistent with the patient’s symptoms. Therefore, MRI is unable to accurately identify the cause of symptoms and quantitatively evaluate nerve injury 2 . Magnetic resonance diffusion tensor imaging (DTI) is a non-invasive method for tracing nerve fiber tracts and evaluating nerve injury.…”

Transcriptomic changes and potential regulatory mechanism of intrauterine human chorionic gonadotropin co-cultured with peripheral blood mononuclear cells infusion in mice with embryonic implantation dysfunction

“…At the same time, we observed a promotion of leukemia inhibitory factor (LIF) and VEGF in endometrium and a higher pregnancy rate in embryo implantation dysfunction (EID) mouse model after a hCG co-cultured with PBMCs infusion (25). We also demonstrated administration of hCG co-cultured with PBMCs for 24 hours could significantly improve the adverse pregnancy outcome of RIF patients, especially for women who had undergone four or more implantation failures (26). However, the mechanisms of hCG co-cultured with PBMCs infusion in promoting a receptive endometrium remain unclear.…”

Anatomical relationship between Kambin’s triangle and exiting nerve root

“…Recently, the diffusion tensor imaging technique has been used for the structural and functional diagnosis of lumbar nerve damage before and after surgery. [19][20][21][22][23] Regarding surgical procedures, Cho et al [24] demonstrated that their floating technique reduces complications during PELD. In their series of 154 patients, none had ENR injury.…”