The Spatial Characteristics of Intervertebral Foramina within the L4/L5 and L5/S1 Motor Segments of the Spine

Nowak, Piotr; Dąbrowski, Mikołaj; Druszcz, Adam; Kubaszewski, Łukasz

doi:10.3390/app14062263

Cited by 2 publications

(1 citation statement)

References 22 publications

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“…Right-handedness, which is predominant in the population, may lead to asymmetrical loading and stress distributions on the lumbar spine due to repetitive motions and postural habits favoring the right side. This asymmetric stress could accelerate degenerative changes in spinal structures, including the intervertebral discs, facet joints, and ligaments, on the dominant side, potentially leading to disparities in foramen size between the left and right sides [ 60 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

Quantifying Lumbar Foraminal Volumetric Dimensions: Normative Data and Implications for Stenosis—Part 2 of a Comprehensive Series

Nurmukhametov,

Encarnacion Ramirez,

Dosanov

et al. 2024

Medical Sciences

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Introduction: Lumbar foraminal stenosis (LFS) occurs primarily due to degenerative changes in older adults, affecting the spinal foramina and leading to nerve compression. Characterized by pain, numbness, and muscle weakness, LFS arises from structural changes in discs, joints, and ligaments, further complicated by factors like inflammation and spondylolisthesis. Diagnosis combines patient history, physical examination, and imaging, while management ranges from conservative treatment to surgical intervention, underscoring the need for a tailored approach. Materials and Methods: This multicenter study, conducted over six years at a tertiary hospital, analyzed the volumetric dimensions of lumbar foramina and their correlation with nerve structures in 500 patients without lumbar pathology. Utilizing high-resolution MRI with a standardized imaging protocol, eight experienced researchers independently reviewed the images for accurate measurements. The study emphasized quality control through the calibration of measurement tools, double data entry, validation checks, and comprehensive training for researchers. To ensure reliability, interobserver and intraobserver agreements were analyzed, with statistical significance determined by kappa statistics and the Student’s t-test. Efforts to minimize bias included blinding observers to patient information and employing broad inclusion criteria to mitigate referral and selection biases. The methodology and findings aim to enhance the understanding of normal lumbar foramina anatomy and its implications for diagnosing and treating lumbar conditions. Results: The study’s volumetric analysis of lumbar foramina in 500 patients showed a progressive increase in foraminal volume from the L1/L2 to the L5/S1 levels, with significant enlargement at L5/S1 indicating anatomical and biomechanical complexity in the lumbar spine. Lateral asymmetry suggested further exploration. High interobserver and intraobserver agreement levels (ICC values of 0.91 and 0.95, respectively) demonstrated the reliability and reproducibility of measurements. The patient cohort comprised 58% males and 42% females, highlighting a balanced gender distribution. These findings underscore the importance of understanding foraminal volume variations for lumbar spinal health and pathology. Conclusion: Our study significantly advances spinal research by quantifying lumbar foraminal volumes, revealing a clear increase from the L1/L2 to the L5/S1 levels, indicative of the spine’s adaptation to biomechanical stresses. This provides clinicians with a precise tool to differentiate between pathological narrowing and normal variations, enhancing the detection and treatment of lumbar foraminal stenosis. Despite limitations like its cross-sectional design, the strong agreement in measurements underscores the method’s reliability, encouraging future research to further explore these findings’ clinical implications.

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Section: Discussionmentioning

confidence: 99%

Quantifying Lumbar Foraminal Volumetric Dimensions: Normative Data and Implications for Stenosis—Part 2 of a Comprehensive Series

Nurmukhametov,

Encarnacion Ramirez,

Dosanov

et al. 2024

Medical Sciences

View full text Add to dashboard Cite

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Exploring Pathways for Pain Relief in Treatment and Management of Lumbar Foraminal Stenosis: A Review of the Literature

Nurmukhametov,

De Jesus Encarnacion Ramirez,

Dosanov

et al. 2024

Brain Sciences

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Background: Lumbar foraminal stenosis (LFS) involves the narrowing of neural foramina, leading to nerve compression, significant lower back pain and radiculopathy, particularly in the aging population. Management includes physical therapy, medications and potentially invasive surgeries such as foraminotomy. Advances in diagnostic and treatment strategies are essential due to LFS’s complexity and prevalence, which underscores the importance of a multidisciplinary approach in optimizing patient outcomes. Method: This literature review on LFS employed a systematic methodology to gather and synthesize recent scientific data. A comprehensive search was conducted across PubMed, Scopus and Cochrane Library databases using specific keywords related to LFS. The search, restricted to English language articles from 1 January 2000 to 31 December 2023, focused on peer-reviewed articles, clinical trials and reviews. Due to the heterogeneity among the studies, data were qualitatively synthesized into themes related to diagnosis, treatment and pathophysiology. Results: This literature review on LFS analyzed 972 articles initially identified, from which 540 remained after removing duplicates. Following a rigorous screening process, 20 peer-reviewed articles met the inclusion criteria and were reviewed. These studies primarily focused on evaluating the diagnostic accuracy, treatment efficacy and pathophysiological insights into LFS. Conclusion: The comprehensive review underscores the necessity for precise diagnostic and management strategies for LFS, highlighting the role of a multidisciplinary approach and the utility of a unified classification system in enhancing patient outcomes in the face of this condition’s increasing prevalence.

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The Spatial Characteristics of Intervertebral Foramina within the L4/L5 and L5/S1 Motor Segments of the Spine

Cited by 2 publications

References 22 publications

Quantifying Lumbar Foraminal Volumetric Dimensions: Normative Data and Implications for Stenosis—Part 2 of a Comprehensive Series

Quantifying Lumbar Foraminal Volumetric Dimensions: Normative Data and Implications for Stenosis—Part 2 of a Comprehensive Series

Exploring Pathways for Pain Relief in Treatment and Management of Lumbar Foraminal Stenosis: A Review of the Literature

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