Correlation of lumbar lateral recess stenosis in magnetic resonance imaging and clinical symptoms

Splettstößer, Annina; Khan, M. Fawad; Zimmermann, Bernd; Vogl, T. J.; Ackermann, Hanns; Middendorp, Marcus; Maataoui, Adel

doi:10.4329/wjr.v9.i5.223

Cited by 41 publications

(37 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A large number of patients with LBP, despite imaging modalities such as MRI, remains without a specific diagnosis (12). Because almost all lumbar structures are plausible sources of LBP, it may serve as a possible cause (13,14). One of the main causes of LBP is IDD of the lumbar spine (15,16).…”

Section: Discussionmentioning

confidence: 99%

Assessment of Lumbar Spine Disc Degeneration in Coherence to Pfirrman Grades and Oswestry Disability Index

Hasanovic-Vučković

Jusufbegović

Vegar-Zubović

et al. 2020

JHSCI

View full text Add to dashboard Cite

Introduction: Intervertebral disc (IVD) degeneration (IDD) is one of the main causes of low back pain (LBP). Standardized diagnostic algorithms for adequate estimation and classification of changes of lumbar discs are mandatory before starting with therapy.Methods: One hundred patients who were indicated for lumbar magnetic resonance imaging (MRI) were included in the study. Pfirrmann grading system was used for the determination of IDD, while the visual analog scale (VAS) is used for evaluation of the intensity of LBP. To quantification of disability for LBP, we used the Oswestry Disability Index (ODI).Result: Results showed higher Pfirrmann grades II and III for L2/L3 and L3/L4 lumbar levels and lower scores at L4/L5 and L5/S1. The analysis also showed low scores at the L2/3 and L3/4 lumbar level for Pfirrmann grades IV and V, and there was an increased at more inferior lumbosacral levels L4/5 and L5/S1. There was a significant correlation between Pfirrmann grades and ODI (p = 0.24) as well as VAS (p = 0.16).Conclusion: Higher Pfirrmann grades correlated with increased ODI and VAS. Therefore, MRI can be used as a strong indicator of clinical appearance, but it is important to take into consideration that LBP should be correlated with clinical features. By summing Pfirrmann grades of all lumbar intervertebral levels in each patient, we can get more accurate insight for the status of the lumbar spine.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessment of Lumbar Spine Disc Degeneration in Coherence to Pfirrman Grades and Oswestry Disability Index

Hasanovic-Vučković

Jusufbegović

Vegar-Zubović

et al. 2020

JHSCI

View full text Add to dashboard Cite

show abstract

“…Despite the fact that the etiology of LSCS is poorly understood, it is clear that LF hypertrophy is known to be one of the main causes contributing to LSCS [ 1 , 2 ]. The experiment explored in this investigation demonstrated that LF thickness in LSCS group was significantly greater than that in the LDH group.…”

Section: Discussionmentioning

confidence: 99%

“…Lumbar spinal canal stenosis (LSCS) is one of the most common diseases in the elderly population often with symptoms of low back and leg pain, numbness, and intermittent claudication arising from nerve compression [ 1 ]. Numerous causative factors such as disc protrusion, the bony proliferation of the facet joints, and hypertrophy of the ligamentum flavum (LF) contribute to the development of LSCS.…”

Section: Introductionmentioning

confidence: 99%

Leptin-induced inflammation by activating IL-6 expression contributes to the fibrosis and hypertrophy of ligamentum flavum in lumbar spinal canal stenosis

et al. 2018

View full text Add to dashboard Cite

The ongoing chronic inflammation and subsequent fibrosis play an important role in ligamentum flavum (LF) fibrosis and hypertrophy in patients with lumbar spinal canal stenosis (LSCS). Leptin is a chronic inflammatory mediator and involved in the fibrotic process in multiple organ systems. The present study aimed to investigate the role of leptin in LF fibrosis and its related regulatory mechanisms. The LF specimens were obtained during the surgery from 12 patients with LSCS (LSCS group) and 12 control patients with lumbar disc herniation (LDH) group. The morphologic changes and fibrosis score of LF were assessed by Hematoxylin and eosin (H&E) and Masson’s trichrome staining respectively. The location and expression of leptin in LF tissues were determined. Then, the LF cells were cultured and exposed to recombinant human leptin (rhleptin). Collagen I and III were used as fibrosis markers and IL-6 was used as the inflammatory factor. As a result, the LF thickness and fibrosis score in the LSCS group were significantly higher than those in the LDH group (P<0.05). Leptin was detected in the hypertrophied LF and its expression was substantially increased in the LSCS group and positively correlated with LF thickness and fibrosis score (P<0.05). Moreover, our in vitro experiments revealed that rhleptin treated LF cells elevated the expression of collagen I and III. Finally, leptin administration induced IL-6 expression via nuclear factor-κB (NF-κB) pathway in LF cell (P<0.05). Our study demonstrated novel molecular events for leptin-induced inflammation in LF tissue by promoting IL-6 expression and thus might have potential implications for clarifying the mechanism underlying LF fibrosis and hypertrophy.

show abstract

“…Lumbar spinal stenosis is caused by a combination of anatomical factors; disc prolapse and bulging, facet joint and ligamentum flavum thickening, osteophyte formation and endplate degeneration amongst them [ 1 – 4 ]. These can occur in isolation or most often as a combination [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…The lateral recess is bordered by the pedicle laterally, the articular facets posteriorly and the vertebral endplate and disc anteriorly [ 4 ]. As with other types of spinal stenosis changing the pedicle length will influence the dimensions of the affected anatomical area.…”

Section: Introductionmentioning

confidence: 99%

Pedicle distraction increases intervertebral and spinal canal area in a cadaver and bone model

Hughes

Papadakos

Bishop

et al. 2018

SICOT-J

View full text Add to dashboard Cite

Introduction: Lumbar spinal stenosis is degenerative narrowing of the spinal canal and/or intervertebral foramen causing compression of the spinal cord and nerve roots. Traditional decompression techniques can often cause significant trauma and vertebral instability. This paper evaluates a method of increasing pedicle length to decompress the spinal and intervertebral foramen, which could be done minimally invasive.Methods: Three Sawbone (Sawbones Europe, Sweden) and 1 cadaveric lumbar spine underwent bilateral pedicle distraction at L4. A pedicle channel was drilled between the superior articular process and transverse process into the vertebral body. The pedicles underwent osteotomy at the midpoint. Screws were inserted bilaterally and fixated distraction of 0 mm, 2 mm, 4 mm and 6 mm. CT images were taken at each level of distraction. Foramen area was measured in the sagittal plane at L3/4. Spinal canal area was measured at L4 in the axial images. The cadaver was used to evaluate safety of osteotomy and soft tissue interactions preventing distraction. Statistical analysis was by student paired t-test and Pearson rank test.Results: Increasing distraction led to greater Spinal canal area. From 4.27 cm2 to 5.72 cm2 (p = 0.002) with 6 mm distraction. A Maximal increase of 34.1%. Vertebral foramen area also increased with increasing pedicle distraction. From 2.43 cm2 to 3.22 cm2 (p = 0.022) with 6 mm distraction. A maximal increase of 32.3%. The cadaver spinal canal increased in area by 21.7%. The vertebral foramen increased in area by 36.2% (left) and 22.6% (right).Discussion: For each increase in pedicle distraction the area of the spinal and vertebral foramen increases. Pedicle distraction could potentially be used to alleviate spinal stenosis and root impingement. A potential osteotomy plane could be at the midpoint of the pedicle with minimal risk to nerve roots and soft tissue restrictions to prevent distraction.

show abstract

Correlation of lumbar lateral recess stenosis in magnetic resonance imaging and clinical symptoms

Cited by 41 publications

References 41 publications

Assessment of Lumbar Spine Disc Degeneration in Coherence to Pfirrman Grades and Oswestry Disability Index

Assessment of Lumbar Spine Disc Degeneration in Coherence to Pfirrman Grades and Oswestry Disability Index

Leptin-induced inflammation by activating IL-6 expression contributes to the fibrosis and hypertrophy of ligamentum flavum in lumbar spinal canal stenosis

Pedicle distraction increases intervertebral and spinal canal area in a cadaver and bone model

Contact Info

Product

Resources

About