Microstructural Changes in Compressed Nerve Roots Are Consistent With Clinical Symptoms and Symptom Duration in Patients With Lumbar Disc Herniation

Wu, Weifei; Liang, Jie; Ru, Neng; Zhou, Chunmei; Chen, Jianfeng; Wu, Yongde; Zong, Yu

doi:10.1097/brs.0000000000001354

Cited by 33 publications

(31 citation statements)

References 27 publications

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“…Except for one continued. article 7) (which showed low ADC), 9 articles [9][10][11]13,15,16,22,23,29) described high ADC in involved nerves and 5 articles demonstrated findings of ADC in healthy subjects 8,18,[24][25][26] . In an asymptomatic case, FA increased and ADC decreased following compression of the nerve root without injury 21) .…”

Section: Measurement Of Dti Parametersmentioning

confidence: 99%

“…All 17 articles 7,[9][10][11][12][13][15][16][17]19,20,22,23,[27][28][29][30] . Except for one continued.…”

Section: Measurement Of Dti Parametersmentioning

confidence: 99%

“…A total of 683 subjects were studied across 24 DTI articles. 177 patients with lumbar spinal canal stenosis (LSCS) in 5 articles 11,12,16,17,20) , 143 patients with lumbar disc herniation (LDH) in 7 articles 7,13,15,20,21,23,29) , 112 patients with lumbar radiculopathy in 3 articles 10,19,22) , 36 patients with foraminal stenosis (FS) in 6 articles 9,11,16,20,27,28) , 2 patients with lower back pain in one article 20) , 3 cases with diastematomyelia and one case with tethered cord in one article 30) , and one case with spina bifida in one article 26) were included. 7 post mortem subjects were investigated in one article 8) .…”

Section: Diffusion-weighted Mr Neurographymentioning

confidence: 99%

“…dex (ODI) 15) , and the Roland-Morris Disability Questionnaire (RDQ) 13) . DTI parameters are useful for diagnosis, quantitative assessment, and follow-up of lumbar nerve entrapment (Fig.…”

Section: A B D Cmentioning

confidence: 99%

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Recent advances in magnetic resonance neuroimaging of lumbar nerve to clinical applications: A review of clinical studies utilizing Dffusion Tensor Imaging and Diffusion-weighted magnetic resonance neurography

Eguchi

Kanamoto

Oikawa³

et al. 2017

Spine Surg Relat Res

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Abstract:Much progress has been made in neuroimaging with Magnetic Resonance neurography and Diffusion Tensor Imaging (DTI) owing to higher magnetic fields and improvements in pulse sequence technology. Reports on lumbar nerve DTI have also increased considerably.Many studies have shown that the use of DTI in lumbar nerve lesions, such as lumbar foraminal stenosis and lumbar disc herniation, makes it possible to capture images of interruptions of tractography at stenotic sties, enabling the diagnosis of stenosis. DTI can also reveal significant decreases in fractional anisotropy (FA) with significant increases in apparent diffusion coefficient (ADC) values in compression lesions.FA values have higher accuracy than ADC values. Furthermore, strong correlations exist between FA values and indications of neurological severity, including the Japanese Orthopedic Association (JOA) score, the Oswestry Disability Index (ODI), and the Roland-Morris Disability Questionnaire (RDQ) in patients with lumbar disc herniation-induced radiculopathy.Most lumbar DTI has become 3T; 3T MRI has made it possible to take high-resolution DTI measurements in a short period of time. However, increased motion artifacts in the magnetic susceptibility effect lead to signal irregularities and image distortion. In the future, high-resolution DTI with reduced field-of-view may become useful in clinical applications, since visualization of nerve lesions and quantification of DTI parameters could allow more accurate diagnoses of lumbar nerve dysfunctions. Future translational studies will be necessary to successfully bring MR neuroimaging of lumbar nerve into clinical use.

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Section: Measurement Of Dti Parametersmentioning

confidence: 99%

“…All 17 articles 7,[9][10][11][12][13][15][16][17]19,20,22,23,[27][28][29][30] . Except for one continued.…”

Section: Measurement Of Dti Parametersmentioning

confidence: 99%

Section: Diffusion-weighted Mr Neurographymentioning

confidence: 99%

“…dex (ODI) 15) , and the Roland-Morris Disability Questionnaire (RDQ) 13) . DTI parameters are useful for diagnosis, quantitative assessment, and follow-up of lumbar nerve entrapment (Fig.…”

Section: A B D Cmentioning

confidence: 99%

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Recent advances in magnetic resonance neuroimaging of lumbar nerve to clinical applications: A review of clinical studies utilizing Dffusion Tensor Imaging and Diffusion-weighted magnetic resonance neurography

Eguchi

Kanamoto

Oikawa³

et al. 2017

Spine Surg Relat Res

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“…Because canalis vertebralis at the T12 and L1 contains the spinal cord, nerve roots and medullary cone, spinal osteotomy at the T12 or L1 vertebra is more dangerous than at lower levels [9] . As a result, T12 or L1 osteotomy is more likely to damage L1 nerve roots, especially in severely rotated vertebra on the convex side, where the L1 nerve roots could penetrate through the surface of vertebra, unlike T12 nerve roots, which causes symptoms such as back pain, muscle weakness and leg numbness, which will in turn influence daily activities [10] .…”

Section: Introductionmentioning

confidence: 99%

Protection of L1 nerve roots in vertebral osteotomy for severe rigid thoracolumbar spine deformity

Liao

Miao

Xie

et al. 2019

Preprint

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Background: This is a retrospective study of the use of parallel endplate osteotomy (PEO) for correction of severe rigid thoracolumbar spine deformity. Methods : From July 2016 to June 2017, 10 patients with severe rigid thoracolumbar spine deformity underwent PEO on T12 or L1 vertebrae were studied. Results : Following PEO performed at T12 or L1, the kyphosis and scoliosis correction rates reached averages of 77.4 ± 8.5% and 76.6 ± 6.8%, intraoperative bleeding 1990 ± 1010 ml, operation time 7.12 ± 3.88 h. One year after surgery, the SF-36 scores of physical function, role-physical, bodily pain, general health, vitality, social function, role-emotional and mental health from 60 ± 30, 47 ± 33, 44 ± 30, 32 ± 18, 50 ±30, 46 ± 29, 26 ± 40 and 52 ± 20 to 81 ± 16, 69 ± 19, 73 ± 11, 66 ± 21, 74 ± 16, 74 ± 24, 63 ± 37 and 76 ± 12, respectively (P < 0.01). Three patients had symptoms of L1 nerve root injury, as reflected by knee extension and hip flexion of lower limb weakness and inner thigh numbness, which further confirmed by electromyography. Conclusions : The parallel endplate osteotomy is simple, results in less bleeding, spinal cord and nerve root under direct vision and can effectively and safely correct severe rigid thoracolumbarspine deformity with better clinical results. However, it is important to identify, separate and protect L1 nerve roots during surgery in cases where patients have symptoms of back pain, muscle weakness and leg numbness on the convex side after surgery. Key words: Thoracolumbar deformity, Nerve roots injury, L1 nerve roots, Parallel endplate osteotomy

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Clinical Value and Reliability of Quantitative Assessments of Lumbosacral Nerve Root Using Diffusion Tensor and Diffusion Weighted MR Imaging: A Systematic Review

Pesesse,

Vanderthommen,

Durieux

et al. 2024

Magnetic Resonance Imaging

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BackgroundLumbosacral radicular pain diagnosis remains challenging. Diffusion tensor imaging (DTI) and diffusion weighted imaging (DWI) have potential to quantitatively evaluate symptomatic nerve root, which may facilitate diagnosis.PurposeTo determine the ability of DTI and DWI metrics, namely fractional anisotropy (FA) and apparent diffusion coefficient (ADC), to discriminate between healthy and symptomatic lumbosacral nerve roots, to evaluate the association between FA and ADC values and patient symptoms, and to determine FA and ADC reliability.Study TypeSystematic review.SubjectsEight hundred twelve patients with radicular pain with or without radiculopathy caused by musculoskeletal‐related compression or inflammation of a single, unilateral lumbosacral nerve root and 244 healthy controls from 29 studies.Field Strength/SequenceDiffusion weighted echo planar imaging sequence at 1.5 T or 3 T.AssessmentAn extensive systematic review of the literature was conducted in Embase, Scopus, and Medline databases. FA and ADC values in symptomatic and contralateral lumbosacral nerve roots were extracted and summarized, together with intra‐ and inter‐rater agreements. Where available, associations between DWI or DTI parameters and patient symptoms or symptom duration were extracted.Statistical TestsThe main results of the included studies are summarized. No additional statistical analyses were performed.ResultsThe DTI studies systematically found significant differences in FA values between the symptomatic and contralateral lumbosacral nerve root of patients suffering from radicular pain with or without radiculopathy. In contrast, identification of the symptomatic nerve root with ADC values was inconsistent for both DTI and DWI studies. FA values were moderately to strongly correlated with several symptoms (eg, disability, nerve dysfunction, and symptom duration). The inter‐ and intra‐rater reliability of DTI parameters were moderate to excellent. The methodological quality of included studies was very heterogeneous.Data ConclusionThis systematic review showed that DTI was a reliable and discriminative imaging technique for the assessment of symptomatic lumbosacral nerve root, which more consistently identified the symptomatic nerve root than DWI. Further studies of high quality are needed to confirm these results.Evidence LevelN/ATechnical EfficacyStage 2

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Microstructural Changes in Compressed Nerve Roots Are Consistent With Clinical Symptoms and Symptom Duration in Patients With Lumbar Disc Herniation

Abstract: 3.

Cited by 33 publications

References 27 publications

Recent advances in magnetic resonance neuroimaging of lumbar nerve to clinical applications: A review of clinical studies utilizing Dffusion Tensor Imaging and Diffusion-weighted magnetic resonance neurography

Recent advances in magnetic resonance neuroimaging of lumbar nerve to clinical applications: A review of clinical studies utilizing Dffusion Tensor Imaging and Diffusion-weighted magnetic resonance neurography

Protection of L1 nerve roots in vertebral osteotomy for severe rigid thoracolumbar spine deformity

Clinical Value and Reliability of Quantitative Assessments of Lumbosacral Nerve Root Using Diffusion Tensor and Diffusion Weighted MR Imaging: A Systematic Review

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