Clinical significance of redundant nerve roots of the cauda equina in lumbar spinal stenosis

2008 ◽  
Vol 110 (1) ◽  
pp. 14-18 ◽  
Author(s):  
Jun-Hong Min ◽  
Jee-Soo Jang ◽  
Sang-Ho Lee
Keyword(s):  
Clinical Significance ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Cauda Equina ◽  
Nerve Roots ◽  
Lumbar Spinal

scholarly journals Dynamic Changes of Cauda Equina Motion Before and After Decompressive Laminectomy for Lumbar Spinal Stenosis With Redundant Nerve Roots: Cauda Equina Activation Sign

2019 ◽  
Vol 9 (6) ◽  
pp. 619-623 ◽  
Author(s):  
Yosuke Kawasaki ◽  
Atsushi Seichi ◽  
Liuzhe Zhang ◽  
Shoichiro Tani ◽  
Atsushi Kimura
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Cauda Equina ◽  
Nerve Roots ◽  
Decompressive Laminectomy ◽  
Before And After ◽  
Lumbar Spinal ◽  
Type 3

Study Design: Cross-sectional observational study (consecutive case series). Objectives: The aim of this study was to define a criterion for achieving successful decompression of lumbar spinal stenosis (LSS) using intraoperative ultrasonography (IOUS) and to investigate the pathogenesis of redundant nerve roots (RNRs) based on the ultrasonographic findings. Methods: A total of 100 LSS patients (71 males, 29 females, mean age, 71 ± 8 years) with RNRs were enrolled as subjects in this study. IOUS was performed to evaluate pulsatile motion of the cauda equina (PMCE) just before and after decompressive laminectomy. To determine the decompression status of the cauda equina, the ultrasonographic findings were classified into 3 types on the basis of the presence or absence of PMCE: type 1, predecompression PMCE (−) to postdecompression PMCE (+); type 2, pre- and postdecompression PMCE (+); and type 3, pre- and postdecompression PMCE (−). The pathogenesis of RNRs was also investigated based on the ultrasonographic findings. Results: Around the stenosis, PMCE was almost always absent before decompression and appeared after decompression (type 1 in 94 patients, type 2 in 6, type 3 in 0). IOUS showed that, before decompression, the cauda equina was held at the stenosis and could not pulsate beyond the stenotic site, and after decompression, PMCE recovered in the craniocaudal direction, leading to the resolution of RNRs. Conclusions: The emergence of PMCE can be a sign of successful decompression for LSS. Ultrasonographic findings support the notion that disturbance of PMCE around the stenosis is a basic component of the pathogenesis of RNRs.

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

2014 ◽  
Vol 72 (10) ◽  
pp. 782-787 ◽  
Author(s):  
Leonor Garbin Savarese ◽  
Geraldo Dias Ferreira-Neto ◽  
Carlos Fernando Pereira da Silva Herrero ◽  
Helton Luiz Aparecido Defino ◽  
Marcello H. Nogueira-Barbosa
Keyword(s):  
Spinal Stenosis ◽  
Cauda Equina ◽  
Intervertebral Discs ◽  
Observer Agreement ◽  
Nerve Roots ◽  
Cross Sectional ◽  
Dural Sac ◽  
Increased Risk ◽  
Independent Risk Factors ◽  
Lumbar Spinal

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 mm2. 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 mm2. LSS and spondylolisthesis are independent risk factors for RNRCE.

scholarly journals Stuburo juosmeninės dalies kanalo stenozė: klinikinė anatomija, diagnostika (I dalis)

2003 ◽  
Vol 1 (4) ◽  
pp. 0-0
Author(s):  
Valentinas Uvarovas ◽  
Giedrius Kvederas ◽  
Igoris Šatkauskas
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Nerve Root ◽  
Cauda Equina ◽  
Neurogenic Claudication ◽  
Clinical Anatomy ◽  
Ageing Population ◽  
Imaging Studies ◽  
Pathologic Features ◽  
Lumbar Spinal

Valentinas Uvarovas, Giedrius Kvederas, Igoris ŠatkauskasVilniaus universiteto Ortopedijos, traumatologijos ir plastinės chirurgijos klinikaVilniaus greitosios pagalbos universitetinė ligoninėŠiltnamių g. 29, LT-2043 VilniusEl paštas: [email protected] Pasaulyje ženkliai auga pagyvenusių žmonių populiacija, kartu daugėja ligų, kuriomis dažniausiai sergama perkopus į antrą gyvenimo pusę. Viena iš tokių ligų yra stuburo kanalo stenozė, t. y. susiaurėjimas. Dažniausia stuburo kanalo stenozės priežastis yra su amžiumi progresuojantys stuburo degeneraciniai pokyčiai. Ne visada arklio uodegos ar nervų šaknelių spaudimas sukelia dirginimo simptomus, tačiau progresuojant patologiniams anatominiams ir fiziologiniams pokyčiams gali išryškėti klinika. Kartais rentgenologiniai duomenys neatspindi klinikos, todėl labai svarbu tiksliai įvertinti ligos simptomus, jų eigą bei rentgenologinius duomenis, kad būtų pasirinkta tinkama gydymo taktika. Prasminai žodžiai: stuburo kanalo stenozė, neurogeninė klaudikacija, nervinės šaknelės, arklio uodega Lumbar spinal stenosis: clinical anatomy, diagnostics Valentinas Uvarovas, Giedrius Kvederas, Igoris Šatkauskas Lumbar spinal stenosis remains one of the most frequently encountered clinical important degenerative spinal disorders in the ageing population. Spinal stenosis is a narrowing or stricture of the spinal canal. Cauda equina and nerve root compression are noted in many asymptomatic individuals. The spinal degenerative process associated with ageing leads to pathoanatomical and pathophysiological changes with occasional clinical consequences. With progressive degenerative changes and compression, spinal stenosis may become symptomatic, although the severity of the symptoms is not necessarily associated with the magnitude of the compression seen on imaging studies. A thorough understanding of the etiology, pathologic features and a correlation between the symptoms and the precise location of the thecal sac and nerve root are very important in evaluating the imaging studies and planning appropriate treatment. Keywords: lumbar spinal stenosis, neurogenic claudication, spinal nerve root, cauda equina

scholarly journals Post-operative Morbidity and Mortality of Lumbar Spinal Stenosis at one Teaching Hospital in North-eastern Benin.

2020 ◽  
Vol 6 (1) ◽  
pp. 13-20
Author(s):  
Holden Olatoundji Fatigba ◽  
◽  
Luphin Hode ◽  
Kisito Quenum ◽  
Thierry Alihonou ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Surgical Management ◽  
Lumbar Spinal Stenosis ◽  
Teaching Hospital ◽  
Cauda Equina ◽  
Canal Stenosis ◽  
Republic Of Benin ◽  
The Republic ◽  
Lumbar Spinal ◽  
Selection Of

Background and Aim: Surgical management of Lumbar Spinal Stenosis (LSS) is a common practice. This study aimed to report the morbidities and mortalities observed during surgical treatment of LSS and the outcome of these patients after management over an 8-year study period. Methods and Materials/Patients: It was a retrospective, descriptive, and transversal study performed at the Departmental Teaching Hospital of Borgou in the Republic of Benin (West Africa) from January 2010 to December 2018. This study included the patients who underwent surgical management for LSS. Type of complication, its management, and the patient’s outcomes was registered. Results: During the study period and based on the selection criteria, 239 patients were selected. These patients were divided into 135 men (56.5%) and 104 women (43.5%). The mean age of the patients was 52.3±10.9 years. Laminectomy was performed on one, two, and three lumbar spinal segments in 17.6%, 55.6% and 26.8% of cases, respectively. Laminectomy was associated with discectomy in 6.3% of the cases. No arthrodesis with spinal fixation was performed. Ninety percent of patients had no post-operative complications. Functional post-operative results were considered excellent, good, acceptable and poor in 32.1%, 52.1%, 10.9% and 4.9% of cases, respectively. Five types of complications were observed in 22 patients (9.2%). A reoperation was performed in 1.6% of cases. These different complications included dural tear (4.6%), wound infection (3.3%), stroke (0.8%), cauda equina syndrome (0.4%) and pseudomeningocele (0.4%). The mortality rate was 0.8% (n=2). Conclusion: Lumbar canal stenosis surgery is not without complications. Careful selection of patients, consideration of risk factors, and selection of an appropriate surgical strategy can reduce or avoid these complications.

Inter-vertebral Height, Inter-vertebral Foramen Height and Range of Motion are Associated with Redundant Nerve Roots in Lumbar Spinal Stenosis

2020 ◽  
Author(s):  
Deng Bo ◽  
Fan Shao Hua ◽  
Feng Xin Bing ◽  
Zhenghua Hong
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Ligamentum Flavum ◽  
Leg Pain ◽  
Intervertebral Foramen ◽  
Vertebral Height ◽  
Nerve Roots ◽  
Vas Scores ◽  
Lumbar Spinal ◽  
Stenotic Segment

Abstract Background: To analyze the relational factors influencing the formation of cauda equina redundant nerve roots (RNRs) of the lumbar spinal stenosis.Methods: A retrospective study of 116 patients with lumbar spinal stenosis were treated in our department from January 2016 to June 2019. Magnetic resonance imaging (MRI) was performed to observe the shape and morphology of the redundant nerve roots of the cauda equina.We divided patient into (RNRs) group and non-RNRs( NRNRs) group based on the presence or absence of RNRs on sagittal T2-weighted MR. We analyzed the demographic characteristics, preoperative back pain visual analogue scale (VAS) scores ,preoperative leg pain VAS scores, and preoperative Oswestry disability index(ODI) scores, and also analyzed the rate of spondylolisthesis and ligamentum flavum hypertrophy. Simultaneously,the inter-vertebral height, intervertebral foramen height, inter-vertebral height +vertebral height, median sagittal diameter at the inter-vertebral space level(DIW-MSD),median sagittal diameter at the pedicel level(DV-MSD),ROM of the stenotic segment, were statistically analyzed for clinical and radiological significance.Results : Of a total 116 total patients,there were no statistically significant differences in either gender [RNRs group (n = 42, 18/24 female) and NRNR group (n = 74, 38/36 female)], age, BMI index, preoperative back pain VAS score , preoperative leg pain VAS score and preoperative ODI score(p> 0.05);however, there were statistically significant differences regard to the duration of symptoms and the rate of spondylolisthesis and ligamentum flavum hypertrophy (p<0.05);the inter-vertebral height,Intervertebral foramen height, inter-vertebral height+vertebral height, DIW-MSD ,ROM of the stenotic segment were also significantly different between the group (p<0.05).Conclusions:The inter-vertebral height, inter-vertebral foramen height, inter-vertebral height + vertebral height, DIW-MSD and ROM of the stenotic segment were the crucial factors related to RNRs in lumbar spinal stenosis.

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