Journal of Korean Neurosurgical Society

  • 제52권3호
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  • Pages.215-220
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  • 2012
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Radiological Significance of Ligamentum Flavum Hypertrophy in the Occurrence of Redundant Nerve Roots of Central Lumbar Spinal Stenosis

  • Hur, Junseok W. (Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Hur, Junho K. (Division of Biology, California Institute of Technology) ;
  • Kwon, Taek-Hyun (Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Park, Youn Kwan (Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Chung, Hung Seob (Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine) ;
  • Kim, Joo Han (Department of Neurosurgery, Korea University Guro Hospital, Korea University College of Medicine)
  • 투고 : 2012.03.14
  • 심사 : 2012.09.17
  • 발행 : 2012.09.28
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초록

Objective : There were previous reports of redundant nerve roots (RNRs) focused on their clinical significance and pathogenesis. In this study, we investigated the significant radiologic findings that correlate with RNRs occurrence. These relations would provide an advanced clue for clinical significance and pathogenesis of RNRs. Methods : Retrospective research was performed with data from 126 patients who underwent surgery for central lumbar spinal stenosis (LSS). Finally, 106 patients with common denominators (inter-observer accuracy : 84%) were included on this study. We divided the patients into two groups by MRI, patients with RNRs and those with no RNRs (NRNRs). Comparative analyses were performed with clinical and radiologic parameters. Results : RNRs were found in 45 patients (42%) with central LSS. There were no statistically significant differences between the two groups in severity of symptoms. On the other hand, we found statistically significant differences in duration of symptom and number of level included (p<0.05). In the maximal stenotic level, ligamentum flavum (LF) thickness, LF cross-sectional area (CSA), dural sac CSA, and segmental angulation are significantly different in RNRs group compared to NRNRs group (p<0.05). Conclusion : RNRs patients showed clinically longer duration of symptoms and multiple levels included. We also confirmed that wide segmental angulation and LF hypertrophy play a major role of the development of RNRs in central LSS. Together, our results suggest that wide motion in long period contribute to LF hypertrophy, and it might be the key factor of RNRs formation in central LSS.

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참고문헌

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