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http://dx.doi.org/10.3340/jkns.2010.47.1.1

The Role of Computed Tomography in the Presurgical Diagnosis of Foraminal Entrapment of Lumbosacral Junction  

Moon, Ki-Hyoung (Department of Neurosurgery, Seoul Wooridul Hospital)
Jang, Jee-Soo (Department of Neurosurgery, Seoul Wooridul Hospital)
Lee, Sang-Ho (Department of Neurosurgery, Wooridul Spine Hospital)
Lee, Su-Chan (Department of Orthopaedic surgery, Mok Dong Himchan Hospital)
Lee, Ho-Yeon (Department of Neurosurgery, Wooridul Spine Hospital)
Publication Information
Journal of Korean Neurosurgical Society / v.47, no.1, 2010 , pp. 1-6 More about this Journal
Abstract
Objective: On the basis of preoperative computed tomography (CT) scans, we studied the change of the size of anterior primary division (APD) of the L5 spinal root in the presence of foraminal/extraforaminal entrapment of the L5 spinal root. Methods: Two independent radiologists retrospectively reviewed the preoperative CT scans of 27 patients treated surgically and compared the sizes of the APDs on bilateral L5 spinal roots. If one side APO size was larger than the other side APD size, it was described as left or right "dominancy" and regarded this as "consensus (C)" in case that there was a consensus between the larger APD and the location of sciatica, and regarded as "non-consensus (NC)" in case that there was not a consensus. Oswestry Disability Index (ODI) scores were used for preoperative and postoperative evaluation. Results: On CT scans, twenty-one (77%) of 27 patients were the consensus group (APD swelling) and 6 (22%) were a non-consensus group (APD no swelling). In 9 patients with acute foraminal disc herniations, asymmetric enlargement of the APD on L5 spinal root was detected in all cases (100%) and detected in 11 (64%) of 17 patients with stenosis. Preoperative ODI score was 75-93 (mean 83) and postoperative 001 scores were improved to 13-36 (mean 21). The mean follow-up period was 6 months (range, 3-11 months). Conclusion: An asymmetric enlargement of the APD on L5 spinal root on CT scans is meaningfully associated with a foraminal or extraforaminal entrapment of the L5 spinal root on the lumbosacral junction.
Keywords
Computed tomography; Foraminal-extraforaminal entrapment; Lumbosacral junction; Radiculopathy; Surgery;
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  • Reference
1 Ido K, Urushidani H : Fibrous adhesive entrapment of lumbosacral nerve roots as a cause of sciatica. Spinal Cord 39 : 269-273, 2001   DOI   ScienceOn
2 Matsumoto M, Chiba K, Nojiri K, Ishikawa M, Toyama Y, Nishikawa Y : Extraforaminal entrapment of the fifth lumbar spinal nerve by osteophytes of the lumbosacral spine : anatomic study and a report of four cases. Spine 27 : E169-E173, 2002   DOI   ScienceOn
3 Wiltse LL, Guyer RD, Spencer CW, Glenn WV, Porter IS : Alar transverse process impingement of the L5 spinal nerve : the far-out syndrome. Spine 9 : 31-41, 1984   DOI   ScienceOn
4 Cramer DG, Darby SA, Frysztak RJ : Pain of spinal origin in Cramer DG, Carby SA (eds) : Basic and Clinical Anatomy of the Spine, Spinal cord, and ANS, ed 2. Philadelphia : Elsevier Mosby, 2005, pp503-504
5 Aota Y, Onari K, An HS, Yoshikawa K : Dorsal root ganglia morphologic features in patients with herniation of the nucleus pulposus : assessment using magnetic resonance myelography and clinical correlation. Spine 26 : 2125-2132, 2001   DOI   ScienceOn
6 Heithoff KB : Computed tomography and plain film diagnosis of the lumbar spine in Weinstein JN, Wiesel SW (eds) : The Lumbar Spine. Philadelphia : Saunders, 1990, pp283-319
7 Cornefjord M, Olmarker K, Farley DB, Weinstein JN, Rydevik B : Neuropeptide changes in compressed spinal nerve roots. Spine 20 : 670-673, 1995   DOI   ScienceOn
8 Nathan H, Weizenbluth M, Halperin N : The lumbosacral ligament (LSL), with special emphasis on the "lumbosacral tunnel" and the entrapment of the 5th lumbar nerve. Int Orthop 6 : 197-202, 1982   DOI
9 Burton CV, Kirkaldy-Willis WH, Yong-Hing K, Heithoff KB : Causes of failure of surgery on the lumbar spine. Clin Orthop Relat Res 157 : 191-199, 1981
10 Aota Y, Niwa T, Yoshikawa K, Fujiwara A, Asada T, Saito T : Magnetic resonance imaging and magnetic resonance myelography in the presurgical diagnosis of lumbar foraminal stenosis. Spine 32 : 896-903, 2007   DOI   ScienceOn
11 Hashimoto M, Watanabe O, Hirano H : Extraforaminal stenosis in the lumbosacral spine. Efficacy of MR imaging in the coronal plane. Acta Radiol 37 : 610-613, 1996   DOI   ScienceOn
12 Cheng TM, Link MJ, Onofrio BM : Pneumatic nerve root compression : epidural gas in association with lateral disc herniation. Report of two cases. J Neurosurg 81 : 453-458, 1994   DOI   ScienceOn
13 Olsewski JM, Simmons EH, Kallen FC, Mendel FC : Evidence from cadavers suggestive of entrapment of fifth lumbar spinal nerves by lumbosacral ligaments. Spine 16 : 336-347, 1991   DOI   ScienceOn
14 Ichihara K, Taguchi T, Hashida T, Ochi Y, Murakami T, Kawai S : The treatment of far-out foraminal stenosis below a lumbosacral transitional vertebra : a report of two cases. J Spinal Disord Tech 17 : 154-157, 2004   DOI
15 Transfeldt EE, Robertson D, Bradford DS : Ligaments of the lumbosacral spine and their role in possible extraforaminal spinal nerve entrapment and tethering. J Spinal Disord 6 : 507-512, 1993   DOI   ScienceOn
16 Lind B, Massie JB, Lincoln T, Myers RR, Swenson MR, Garfin SR : The effects of induced hypertension and acute graded compression on impulse propagation in the spinal nerve roots of the pig. Spine 18 : 1550-1555, 1993