scholarly journals Radiological Significance of Ligamentum Flavum Hypertrophy in the Occurrence of Redundant Nerve Roots of Central Lumbar Spinal Stenosis

2012 ◽  
Vol 52 (3) ◽  
pp. 215 ◽  
Author(s):  
Junseok W Hur ◽  
Junho K Hur ◽  
Taek-Hyun Kwon ◽  
Youn Kwan Park ◽  
Hung Seob Chung ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Ligamentum Flavum ◽  
Nerve Roots ◽  
Lumbar Spinal

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.

Immunohistochemical Study of the Ligamentum Flavum in the Lumbar Spinal Stenosis

1995 ◽  
Vol 30 (6) ◽  
pp. 1551
Author(s):  
Dae Moo Shim ◽  
Sang Soo Kim ◽  
In Yong Choi ◽  
Jae Yong Song ◽  
Hyung Bae Moon
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Ligamentum Flavum ◽  
Immunohistochemical Study ◽  
Lumbar Spinal

scholarly journals Histopathological Analysis of Ligamentum Flavum in Lumbar Spinal Stenosis and Disc Herniation

2017 ◽  
Vol 11 (1) ◽  
pp. 71-74 ◽  
Author(s):  
Idiris Altun ◽  
Kasım Zafer Yüksel
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Disc Herniation ◽  
Ligamentum Flavum ◽  
Elastic Fiber ◽  
Leg Pain ◽  
Histopathological Analysis ◽  
Significant Difference ◽  
Fiber Number ◽  
Lumbar Spinal

<sec><title>Study Design</title><p>Histopathological analyses were performed in ligamentum flavum (LF) hypertrophy patients with lumbar spinal stenosis (LSS) and lumbar disc herniation (LDH).</p></sec><sec><title>Purpose</title><p>The aim of the present study was to evaluate histopathological changes in LF patients with LSS and LDH.</p></sec><sec><title>Overview of Literature</title><p>LSS is the most common spinal disorder in elderly patients. This condition causes lower back and leg pain and paresis, and occurs as a result of degenerative changes in the lumbar spine, including bulging of the intervertebral discs, bony proliferation of the facet joints, and LF thickening; among these, LF thickening is considered a major contributor to the development of LSS.</p></sec><sec><title>Methods</title><p>A total of 71 patients operated with the surgical indications of LSS and LDH were included. LF samples were obtained from 31 patients who underwent decompressive laminectomy for symptomatic degenerative LSS (stenotic group) and from 40 patients who underwent lumbar discectomy for LDH (discectomy group). LF materials were examined histopathologically, and other specimens were examined for collagen content, elastic fiber number and array, and presence of calcification.</p></sec><sec><title>Results</title><p>The stenotic and discectomy groups did not differ with regard to mean collagen concentration or mean elastic fiber number (p=0.430 and p=0.457, respectively). Mean elastic fiber alignment was 2.36±0.99 in the stenotic group and 1.38±0.54 in the discectomy group (<italic>p</italic>&lt;0.001). Mean calcification was 0.39±0.50 in the stenotic group, whereas calcification was not detected (0.00±0.00) in the discectomy group; a statistically significant difference was detected (<italic>p</italic>&lt;0.001) between groups.</p></sec><sec><title>Conclusions</title><p>LF hypertrophy in spinal stenosis may occur as a result of elastic fiber misalignment along with the development of calcification over time. Further studies determining the pathogenesis of LSS are needed.</p></sec>

scholarly journals Redundant nerve roots in lumbar spinal stenosis: inter- and intra-rater reliability of an MRI-based classification

2019 ◽  
Vol 62 (2) ◽  
pp. 223-230 ◽  
Author(s):  
Luca Papavero ◽  
Carlos J. Marques ◽  
Jens Lohmann ◽  
Thies Fitting ◽  
Kathrin Schawjinski ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Nerve Roots ◽  
Severe Stenosis ◽  
Rater Reliability ◽  
Microsurgical Decompression ◽  
Orthopedic Surgeons ◽  
Symptom History ◽  
Lumbar Spinal

Abstract Purpose Patients with central lumbar spinal stenosis (LSS) have a longer symptom history, more severe stenosis, and worse postoperative outcomes, when redundant nerve roots (RNRs) are evident in the preoperative MRI. The objective was to test the inter- and intra-rater reliability of an MRI-based classification for RNR. Methods This is a retrospective reliability study. A neuroradiologist, an orthopedic surgeon, a neurosurgeon, and three orthopedic surgeons in-training classified RNR on 126 preoperative MRIs of patients with LSS admitted for microsurgical decompression. On sagittal and axial T2-weighted images, the following four categories were classified: allocation (A) of the key stenotic level, shape (S), extension (E), and direction (D) of the RNR. A second read with cases ordered differently was performed 4 weeks later. Fleiss and Cohen’s kappa procedures were used to determine reliability. Results The allocation, shape, extension, and direction (ASED) classification showed moderate to almost perfect inter-rater reliability, with kappa values (95% CI) of 0.86 (0.83, 0.90), 0.62 (0.57, 0.66), 0.56 (0.51, 0.60), and 0.66 (0.63, 0.70) for allocation, shape, extension, and direction, respectively. Intra-rater reliability was almost perfect, with kappa values of 0.90 (0.88, 0.92), 0.86 (0.84, 0.88), and 0.84 (0.81, 0.87) for shape, extension, and direction, respectively. Intra-rater kappa values were similar for junior and senior raters. Kappa values for inter-rater reliability were similar between the first and second reads (p = 0.06) among junior raters and improved among senior raters (p = 0.008). Conclusions The MRI-based classification of RNR showed moderate-to-almost perfect inter-rater and almost perfect intra-rater reliability.

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