Redundant lumbar nerve root syndrome: myelographic features.

Hacker, D. A.; Latchaw, Richard E.; Yock, Douglas H.; Ghosharjura, K.; Gold, Lawrence H. A.

doi:10.1148/radiology.143.2.6280235

Cited by 20 publications

(20 citation statements)

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“…Redundant nerve roots are associated with severe spinal stenosis and may be seen on the cephalic side of the block in the lumbar region [8]. Single-slice MR myelography clearly depicts tortuous, elongated nerve roots (Fig.…”

Section: Degenerative Spinal Stenosismentioning

confidence: 99%

High-Resolution Single-Slice MR Myelography

Nagayama

Watanabe²,

Okumura³

et al. 2002

American Journal of Roentgenology

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R myelography is a noninvasive technique that can provide anatomic information about the subarachnoid space. Major advantages of MR myelography over conventional radiographic myelography include its lack of ionizing radiation, noninvasive nature, and lack of need for intrathecal contrast material [1]. Two techniques, based on slice selection, are currently in use: multislice MR myelography and single-slice MR myelography. Multislice MR myelography requires a relatively long imaging time. The image quality is often degraded by artifacts arising from cerebrospinal fluid pulsatile flow and background signal contribPictorial Essay M A B Fig. 1.-Single-slice MR myelography in healthy 35-year-old male volunteer. A, Cervical spine single-slice MR myelogram obtained in posterior view shows spinal cord as filling defect in thecal sac containing hyperintense cerebrospinal fluid. Nerve root sleeves are shown as symmetric tentlike or sleevelike protrusions from thecal sac margin (arrows). B, Lumbar spine single-slice MR myelogram obtained in posterior view shows individual nerve roots (arrows) extending from spinal cord to nerve root sleeves and cauda equina.Fig. 2.-Conjoined nerve root in 39-year-old man. Single-slice MR myelogram reveals that two nerve roots (arrow) of right side share common proximal sleeve at level of sacrum. Tortuous fine vessel (arrowheads) on surface of lumbosacral spinal cord is normal finding. Downloaded from www.ajronline.org by 203.115.120.250 on 10/04/15 from IP address 203.115.120.250.

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Section: Degenerative Spinal Stenosismentioning

confidence: 99%

High-Resolution Single-Slice MR Myelography

Nagayama

Watanabe²,

Okumura³

et al. 2002

American Journal of Roentgenology

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“…Redundant nerve roots of the cauda equina (RNRCE) are characterised in magnetic resonance images (MRIs) of the lumbosacral spinal cord by the presence of elongated and tortuous nerve roots with a serpiginous or coiled appearance and near an area of spinal canal stenosis 1,2,3,4,5,6,7,8 . The literature describes this entity in association with degenerative spinal canal stenosis ( Figure 1).…”

Section: Introductionmentioning

confidence: 99%

Cauda equina redundant nerve roots are associated to the degree of spinal stenosis and to spondylolisthesis

Savarese

Ferreira-Neto²,

Herrero

et al. 2014

Arq. Neuro-Psiquiatr.

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To evaluate the association of redundant nerve roots of cauda equina (RNRCE) with the degree of lumbar spinal stenosis (LSS) and with spondylolisthesis. Method: After Institutional Board approval, 171 consecutive patients were retrospectively enrolled, 105 LSS patients and 66 patients without stenosis. The dural sac cross-sectional area (CSA) was measured on T2w axial MRI at the level of L2-3, L3-4 and L4-5 intervertebral discs. Two blinded radiologists classified cases as exhibiting or not RNRCE in MRI. Intra-and inter-observer reproducibility was assessed. Results: RNRCE were associated with LSS. RRNCE was more frequent when maximum stenosis,55 mm 2 . Substantial intra-observer agreement and moderate inter-observer agreement were obtained in the classification of RNRCE. Spondylolisthesis was identified in 27 patients and represented increased risk for RRNCE. Conclusion: LSS is a risk factor for RNRCE, especially for dural sac CSA,55 mm 2 . LSS and spondylolisthesis are independent risk factors for RNRCE.Keywords: magnetic resonance imaging, spinal nerve roots, cauda equina, spinal stenosis, spondylolisthesis. RESUMOAvaliar associação entre raízes nervosas redundantes da cauda eqüina (RNRCE) com grau de estenose do canal lombar (ECL) e espondilolistese. Método: Após aprovação do Comitê de Ética, 171 pacientes foram selecionados retrospectivamente, 105 com ECL e 66 sem estenose. Foram realizadas mensurações da área seccional do saco dural em imagens axiais de RM ponderadas em T2 em L2/L3, L3/L4 e L4/ L5. Presença ou não de RRNCE foi classificada de forma independente por dois radiologistas, às cegas. Concordância intra e inter-observador foi analisada. Resultados: RNRCE foi associada à ECL e foi mais freqüente quando a máxima estenose encontrada foi ,55mm 2. Houve grande concordância intra-observador e moderada inter-observador na classificação das RRNCE. Espondilolistese foi identificada em 27 pacientes e representou maior risco para desenvolvimento de RNRCE. Conclusão: ECL é fator de risco para RNRCE, especialmente com áreas seccionais ,55mm 2. ECL e espondilolistese representam fatores de risco independentes para desenvolvimento de RNRCE.Palavras-chave: ressonância magnética, raizes nervosas, cauda equina, estenose espinhal, espondilolistese.Redundant nerve roots of the cauda equina (RNRCE) are characterised in magnetic resonance images (MRIs) of the lumbosacral spinal cord by the presence of elongated and tortuous nerve roots with a serpiginous or coiled appearance and near an area of spinal canal stenosis 1,2,3,4,5,6,7,8 . The literature describes this entity in association with degenerative spinal canal stenosis (Figure 1). It is believed that the acquired elongation of the nerve roots is due to a chronic compression force at the level of the lumbar spinal stenosis (LSS) 9 . This condition is not a new or separate disease but may be part of the natural evolution of lumbar canal stenosis.The recognition of RNRCE in diagnostic imaging is especially important for avoiding the misdiagnosis of other dis...

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“…The radiographic criterion for central spinal stenosis was a sagittal diameter of the dura less than 10.5 mm in an extended position [17]. Furthermore, the coexistence of bilateral indentation of the dura and intradural redundant nerve roots (serpentine filling defects) was documented [13,16]. Fig.…”

Section: Methodsmentioning

confidence: 99%

Spinal stenosis subsequent to juvenile lumbar osteochondrosis

Tallroth

Schlenzka

1990

Skeletal Radiol.

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This paper describes eight patients with spinal stenosis associated with marked osteochondrous changes in the vertebral bodies due to juvenile lumbar osteochondrosis (Scheuermann's disease). In no case was the midsagittal or interpedicular diameter of the spinal canal indicative of bony stenosis. On the other hand, in the myelograms the sagittal diameter of the dural sac was in all cases significantly narrowed, a diagnostic sign of central spinal stenosis. Therefore, myelography should always be contemplated when osteochondrous changes are present and spinal stenosis is suspected clinically regardless of whether the spinal canal diameters are normal in plain films.

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Redundant lumbar nerve root syndrome: myelographic features.

Cited by 20 publications

References 0 publications

High-Resolution Single-Slice MR Myelography

High-Resolution Single-Slice MR Myelography

Cauda equina redundant nerve roots are associated to the degree of spinal stenosis and to spondylolisthesis

Spinal stenosis subsequent to juvenile lumbar osteochondrosis

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