The Surgical Treatment of Nerve Root Compression Caused by Scoliosis of the Lumbar Spine

AbstractBackground:Patients with lumbar spine complaints are often referred for surgical assessment. Only those with clinical and radiological evidence of nerve root compression are potential candidates for surgery and appropriate for surgical assessment. This study examines the appropriateness of lumbar spine referrals made to neurosurgeons in Edmonton, Alberta.Methods:Lumbar spine referrals to a group of ten neurosurgeons at the University of Alberta were reviewed over three two month intervals. Clinical criteria for “appropriateness” for surgical assessment were as follows: •“Appropriate” referrals were those that stated leg pain was the chief complaint, or those that described physical exam evidence of neurological deficit, and imaging reports (CT or MRI) were positive for nerve root compression. •“Uncertain” referrals were those that reported both back and leg pain without specifying which was greater, without mention of neurologic deficit, and when at least possible nerve root compression was reported on imaging. •“Inappropriate” referrals contained no mention of leg symptoms or signs of neurological deficit, and/or had no description of nerve root compression on imaging.Results:Of the 303 referrals collected, 80 (26%) were appropriate, 92 (30%) were uncertain and 131 (44%) were inappropriate for surgical assessment.Conclusions:Physicians seeking specialist consultations for patients with lumbar spine complaints need to be better informed of the criteria which indicate an appropriate referral for surgical treatment, namely clinical and radiological evidence of nerve root compression. Avoiding inappropriate referrals could reduce wait-times for both surgical consultation and lumbar spine surgery for those patients requiring it.

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Surgical treatment of nerve root compression caused by scoliosis of the lumbar spine

Journal of Neurosurgery ◽

10.3171/jns.1974.41.4.0449 ◽

1974 ◽

Vol 41 (4) ◽

pp. 449-454 ◽

Cited By ~ 22

Author(s):

Joseph A. Epstein ◽

Bernard S. Epstein ◽

Leroy S. Lavine

Keyword(s):

Surgical Treatment ◽

Lumbar Spine ◽

Elderly Patients ◽

Recovery Of Function ◽

Radicular Pain ◽

Surgical Decompression ◽

Nerve Root Compression ◽

Pathological Anatomy ◽

Content Type ◽

Fine Print

✓ Effective relief of radicular pain and recovery of function is reported in four elderly patients with lumbar scoliosis following surgical decompression of the lateral recesses of the spinal canal. The operation includes laminectomy or hemilaminectomy with unroofing of the lateral recesses and foramina by medial facetectomy or facetectomy. The patients tolerated surgery without morbidity, were walking within 2 or 3 days, and recovered without incident. The pathological anatomy and operative criteria are discussed.

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The Triad of Nerve Root Enhancement, Thickening, and Displacement in Patients with Sciatica and Recurrent Disk Herniation in the Postoperative Lumbar Spine May Prompt Further Surgical Treatment in Patients with Failed-Back Surgical Syndrome

American Journal of Neuroradiology ◽

10.3174/ajnr.a1552 ◽

2009 ◽

Vol 30 (5) ◽

pp. 1068-1069

Author(s):

G. Chaljub ◽

R.D. Sullivan ◽

J.T. Patterson

Keyword(s):

Surgical Treatment ◽

Lumbar Spine ◽

Nerve Root ◽

Disk Herniation

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Chondroma of the Lumbar Spine, a Rare Cause of Sciatica: Case Report

Neurosurgery ◽

10.1227/00006123-199004000-00022 ◽

1990 ◽

Vol 26 (4) ◽

pp. 685-688 ◽

Cited By ~ 5

Author(s):

Linda I. Bland ◽

Joseph V. McDonald

Keyword(s):

Case Report ◽

Lumbar Spine ◽

Nerve Root ◽

Benign Tumor ◽

Nerve Root Compression ◽

Radicular Symptoms

Abstract A case of chondroma of the lumbar spine causing nerve root compression is presented. This benign tumor was completely removed, resulting in relief of all radicular symptoms.

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Utility of Limited Protocol Magnetic Resonance Imaging Lumbar Spine for Nerve Root Compression in a Developing Country, Is It Accurate and Cost Effective?

Asian Spine Journal ◽

10.4184/asj.2013.7.3.184 ◽

2013 ◽

Vol 7 (3) ◽

pp. 184 ◽

Cited By ~ 3

Author(s):

Kiran Hilal ◽

Zafar Sajjad ◽

Raza Sayani ◽

Dawar Khan

Keyword(s):

Magnetic Resonance Imaging ◽

Lumbar Spine ◽

Magnetic Resonance ◽

Developing Country ◽

Nerve Root ◽

Cost Effective ◽

Nerve Root Compression ◽

Resonance Imaging

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PROSPECTIVE STUDY OF CORREALTION OF MRI FINDINGS AND CLINCAL SYMPTOMS IN LUMBAR SPINE DEGENERATIVE DISEASE

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v4i2.922 ◽

2020 ◽

Vol 4 (2) ◽

Author(s):

Solanki Kunal G ◽

Matadar Hadin M

Keyword(s):

Lumbar Spine ◽

Disc Degeneration ◽

Disc Herniation ◽

Nerve Root ◽

Facet Joint ◽

Modic Changes ◽

Degenerative Disease ◽

Nerve Root Compression ◽

Canal Stenosis ◽

Disc Bulge

Introduction: Degenerative disease of the lumbar spine is a broad terminology which includes disc degeneration, Modic changes, disc displacement, facet joint arthropathy and associated complications. The modality of choice for imaging degenerative disease of lumbar spine is Magnetic Resonance Imaging (MRI) due to excellent soft tissue spatial resolution and better tissue segregation.The aim of this study was to establish correlation of MRI Findings and Clinical symptoms in lumbar spine degenerative disease. Material and Methods: This descriptive cross-sectional study involved 100 patients; lumbar MRI scans were performed through L1 to S1 Intervertebral disc spaces. Clinical presenting symptoms of the patients were noted , followed by MRI in which mainly six degenerative findings were looked at which were disc degeneration, Modic changes, disc bulge, disc herniation, central canal stenosis and nerve root compression. Results: Most frequent degenerative finding on MRI, in markedly symptomatic patients was disc degeneration seen in 100% of patients, followed by diffuse disc bulge (92.5%) and nerve root compression (82.5%). The least common finding was Facet Joint Hypertrophy seen in 22.9% of patients. In Degenerative imaging findings there was no significant sex difference. Degenerative findings were more common at lower lumbar levels (L4/L5&L5/S1). Disc degeneration, disc herniations, central canal stenosis and nerve root compression were common in patients with radiculopathy than in patients with low back pain only. In Minimally symptomatic patients disc herniation was not seen in any patient. Conclusion:. The most frequent degenerative finding in markedly symptomatic patients was disc degeneration followed by diffuse disc bulge and nerve root compression. Posterolateral was the most common location for disc herniation. Disc herniation, disc degeneration, canal stenosis and nerve root compression were significantly seen in patients with radiculopathy. There were no sequestered discs found in the studied patients. All degenerative findings excluding disc herniation were also seen in lesser prevalence in minimally symptomatic patients. Keywords: Degenerative Disease, Lumbar Spine, MRI, Disc Degeneration, Disc Herniation, Modic Changes, Clinical Symptoms, Back pain

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