Comparison of metric analysis of spinal structures, exemplarily of the ligamentum flavum, obtained with CT and MRI

Schulte, Tobias L.; Heidenreich, J; Schilling, A.; Stendel, R.; Pietilä, Terttu; Hopfenmüller, Werner; Brock, M.; Wolf, Karl‐Jürgen

doi:10.1016/j.ejrad.2003.11.022

Cited by 12 publications

(8 citation statements)

References 17 publications

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“…The intra and inter personal variations of the measurements were similar to those reported by others [13]. The consistent finding of an increased thickness and area of the yellow ligament in every loaded subject supported the validity of the results.…”

Section: Strengthssupporting

confidence: 77%

The narrowing of the lumbar spinal canal during loaded MRI: the effects of the disc and ligamentum flavum

et al. 2009

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Load and activity changes of the spine typically cause symptoms of nerve root compression in subjects with spinal stenosis. Protrusion of the intervertebral disc has been regarded as the main cause of the compression. The objective was to determine the changes in the size of the lumbar spinal canal and especially those caused by the ligamentum flavum and the disc during loaded MRI. For this purpose an interventional clinical study on consecutive patients was made. The lumbar spines in 24 supine patients were examined with MRI: first without any external load and then with an axial load corresponding to half the body weight. The effect of the load was determined through the cross-sectional areas of the spinal canal and the ligamentum flavum, the thickness of ligamentum flavum, the posterior bulge of the disc and the intervertebral angle. External load decreased the size of the spinal canal. Bulging of the ligamentum flavum contributed to between 50 and 85% of the spinal canal narrowing. It was concluded that the ligamentum flavum, not the disc had a dominating role for the load induced narrowing of the lumbar spinal canal, a finding that can improve the understanding of the patho-physiology in spinal stenosis.

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Section: Strengthssupporting

confidence: 77%

The narrowing of the lumbar spinal canal during loaded MRI: the effects of the disc and ligamentum flavum

et al. 2009

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“…CT and MRI have been used to measure the thickness of the LF because they are easy to perform, repeatable, and cost effective. Schulte et al (2004) reported that the measurement results using CT and MRI were identical. MRI of the lumbar spine, which is already an effective technique for evaluating disk disease, is also valuable for identifying degenerative changes in the facet joints and ligamentous structures of the spinal canal (Grenier et al, 1987).…”

Section: Discussionmentioning

confidence: 90%

The thickness of the ligamentum flavum in relation to age and gender

et al. 2009

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Hypertrophy of the ligamentum flavum (LF) can reduce the diameter of the spinal canal posteriorly. Such stenosis may significantly compress the dural sac and nerve roots, resulting in symptoms, even without a bulging anulus fibrosus or herniated nucleus pulposus. We conducted an anatomical study to determine the influence of age and gender on the thickness of the LF at the lower lumbar levels using magnetic resonance imaging (MRI). The thickness of 1,280 ligaments was determined at the L4-L5 and L5-S1 levels from MRIs. We screened 320 patients (152 males [47.5%] and 168 females [52.5%]) between 21 and 82 years of age. There were no significant differences in LF thickness with respect to gender (P > 0.05). Age was not correlated with the thicknesses of the LF. The left LF at the L4-L5 and L5-S1 levels was significantly thicker than on the right side (P < 0.05). Furthermore, the LF thicknesses at L5-S1 bilaterally were significantly greater than on the corresponding sides at L4-L5 (P < 0.05). The LF is an important anatomical structure, which might cause low back or leg pain. Therefore, the thickness of the LF should be measured and evaluated carefully in the case of spinal stenosis.

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“…Consecutive 0.2 cm thick serial 1.5 Tesla MRI (Philips Systems, Netherlands) from axial T1 weighted with SE T1A (TR 500–700 ms, TE 10–30 ms) was selected to measure disc spaces, spinal canal diameters and ligamentum flavum with a millimetric caliper. On the T1-weighted axial images through the facet joint, the thickness at the middle portion of the ligamentum flavum of all these patients was measured bilaterally at the level of disc herniation ( Figure 2 ), as described in a previous study [ 6 ]. All measurements were performed blinded to subject details, and were done three times in each trial by an anatomist and blinded neurosurgeon independently.…”

Section: Methodsmentioning

confidence: 99%

Effect of ligamenta flava hypertrophy on lumbar disc herniation with contralateral symptoms and signs: a clinical and morphometric study

Karabekir¹,

Yildizhan²,

Atar³

et al. 2010

aoms

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IntroductionThe purpose of this study was to determine whether ligamentum flavum hypertrophy among disc herniated patients causes contralateral pain symptoms. For this reason we measured the thickness of the ligament in disc herniated patients with ipsilateral or contralateral symptoms.Material and methodsTwo hundred disc herniated patients with ipsilateral symptoms as group I were compared with five disc herniated patients with only contralateral symptoms as group II. Ligamenta flava thicknesses and spinal canal diameters of both groups were measured on magnetic resonance imaging (MRI) with a micro-caliper.ResultsBoth groups underwent surgery only on the disc herniated side. The total thicknesses of the ligamenta flava in group II was thicker than in group I. There was no spinal stenosis in either group and no significance difference between the groups. Statistically significant differences were found for both ipsilateral and contralateral thickness of the ligament flava in both groups. We also compared thickness of the ligamenta flava for each level of disc herniation in group I; ligamenta flava hypertrophy was more common at L3-L4 and L4-L5 levels of vertebrae in females.ConclusionsAetiology of contralateral sciatica among disc herniated patients may be related to hypertrophy of the ligamenta flava, especially on the opposite side. Surgical approaches of the disc herniated side alone may be sufficient for a good outcome.

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Comparison of metric analysis of spinal structures, exemplarily of the ligamentum flavum, obtained with CT and MRI

Cited by 12 publications

References 17 publications

The narrowing of the lumbar spinal canal during loaded MRI: the effects of the disc and ligamentum flavum

The narrowing of the lumbar spinal canal during loaded MRI: the effects of the disc and ligamentum flavum

The thickness of the ligamentum flavum in relation to age and gender

Effect of ligamenta flava hypertrophy on lumbar disc herniation with contralateral symptoms and signs: a clinical and morphometric study

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