The prevalence of redundant nerve roots in patients with lumbar spinal stenosis is body position dependent: a retrospective observational study with repeated measures design in an upright MRI scanner
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Media type:
E-Article
Title:
The prevalence of redundant nerve roots in patients with lumbar spinal stenosis is body position dependent: a retrospective observational study with repeated measures design in an upright MRI scanner
Contributor:
Papavero, Luca;
Ebert, Stella;
Marques, Carlos J.
imprint:
Springer Science and Business Media LLC, 2020
Description:
<jats:title>Abstract</jats:title><jats:sec>
<jats:title>Purpose</jats:title>
<jats:p>Redundant nerve roots (RNRs) are a negative prognostic factor in patients with central lumbar spinal stenosis (LSS). Forty percent of candidates for surgical decompression show RNRs (RNR+) on preoperative conventional magnetic resonance imaging (MRI). We investigated the prevalence of RNRs in three functional postures (standing, neutral sitting and flexed sitting) with an upright MRI (upMRI).</jats:p>
</jats:sec><jats:sec>
<jats:title>Methods</jats:title>
<jats:p>A retrospective observational study with a repeated measures design. Thirty surgical candidates underwent upMRI. Sagittal and axial T2-weighted images of the three functional postures were evaluated. The segmental length of the lumbar spine (sLLS), the lordotic angle (LA) and the dural cross-sectional area (DCSA) were measured in each body position. Generalized linear mixed models were carried out. The 0.05 level of probability was set as the criterion for statistical significance.</jats:p>
</jats:sec><jats:sec>
<jats:title>Results</jats:title>
<jats:p>The prevalence of RNRs decreased from 80% during standing to 16.7% during flexed sitting (<jats:italic>p</jats:italic> < 0.001). The sLLS increased significantly from standing to neutral sitting in both RNR groups (<jats:italic>p</jats:italic> < 0.001). The increase from neutral sitting to flexed sitting was only significant (<jats:italic>p</jats:italic> < 0.001) for the group without RNRs (RNR−). The LA decreased significantly for both RNR groups from standing to flexed sitting (<jats:italic>p</jats:italic> < 0.001). The DSCA increased significantly in the RNR− group (<jats:italic>p</jats:italic> < 0.001) but not in the RNR+ group (<jats:italic>p</jats:italic> = 0.9).</jats:p>
</jats:sec><jats:sec>
<jats:title>Conclusion</jats:title>
<jats:p>The prevalence of RNRs is body position dependent. Increases in DCSA play a determinant role in resolving RNRs.</jats:p>
</jats:sec>