Serpentine Myelographic Defect Caused by a Redundant Nerve Root

Cressman, Marvin R.; Pawl, Ronald P.

doi:10.3171/jns.1968.28.4.0391

Cited by 55 publications

(36 citation statements)

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“…Our study statistically confirmed the association between the presence of spinal canal stenosis and redundant nerve roots. Although this association is not new in the literature, previously published studies were either based on case series or did not have a control group 1,2,3,4,5,6,9,10,11,17 . In our study, patients with spinal canal stenosis had a higher likelihood of exhibiting RNRCE compared with the group of patients without stenosis.…”

Section: Discussionmentioning

confidence: 99%

“…Redundant nerve roots of the cauda equina (RNRCE) are characterised in magnetic resonance images (MRIs) of the lumbosacral spinal cord by the presence of elongated and tortuous nerve roots with a serpiginous or coiled appearance and near an area of spinal canal stenosis 1,2,3,4,5,6,7,8 . The literature describes this entity in association with degenerative spinal canal stenosis ( Figure 1).…”

Section: Introductionmentioning

confidence: 99%

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Cauda equina redundant nerve roots are associated to the degree of spinal stenosis and to spondylolisthesis

Savarese

Ferreira-Neto²,

Herrero

et al. 2014

Arq. Neuro-Psiquiatr.

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To evaluate the association of redundant nerve roots of cauda equina (RNRCE) with the degree of lumbar spinal stenosis (LSS) and with spondylolisthesis. Method: After Institutional Board approval, 171 consecutive patients were retrospectively enrolled, 105 LSS patients and 66 patients without stenosis. The dural sac cross-sectional area (CSA) was measured on T2w axial MRI at the level of L2-3, L3-4 and L4-5 intervertebral discs. Two blinded radiologists classified cases as exhibiting or not RNRCE in MRI. Intra-and inter-observer reproducibility was assessed. Results: RNRCE were associated with LSS. RRNCE was more frequent when maximum stenosis,55 mm 2 . Substantial intra-observer agreement and moderate inter-observer agreement were obtained in the classification of RNRCE. Spondylolisthesis was identified in 27 patients and represented increased risk for RRNCE. Conclusion: LSS is a risk factor for RNRCE, especially for dural sac CSA,55 mm 2 . LSS and spondylolisthesis are independent risk factors for RNRCE.Keywords: magnetic resonance imaging, spinal nerve roots, cauda equina, spinal stenosis, spondylolisthesis. RESUMOAvaliar associação entre raízes nervosas redundantes da cauda eqüina (RNRCE) com grau de estenose do canal lombar (ECL) e espondilolistese. Método: Após aprovação do Comitê de Ética, 171 pacientes foram selecionados retrospectivamente, 105 com ECL e 66 sem estenose. Foram realizadas mensurações da área seccional do saco dural em imagens axiais de RM ponderadas em T2 em L2/L3, L3/L4 e L4/ L5. Presença ou não de RRNCE foi classificada de forma independente por dois radiologistas, às cegas. Concordância intra e inter-observador foi analisada. Resultados: RNRCE foi associada à ECL e foi mais freqüente quando a máxima estenose encontrada foi ,55mm 2. Houve grande concordância intra-observador e moderada inter-observador na classificação das RRNCE. Espondilolistese foi identificada em 27 pacientes e representou maior risco para desenvolvimento de RNRCE. Conclusão: ECL é fator de risco para RNRCE, especialmente com áreas seccionais ,55mm 2. ECL e espondilolistese representam fatores de risco independentes para desenvolvimento de RNRCE.Palavras-chave: ressonância magnética, raizes nervosas, cauda equina, estenose espinhal, espondilolistese.Redundant nerve roots of the cauda equina (RNRCE) are characterised in magnetic resonance images (MRIs) of the lumbosacral spinal cord by the presence of elongated and tortuous nerve roots with a serpiginous or coiled appearance and near an area of spinal canal stenosis 1,2,3,4,5,6,7,8 . The literature describes this entity in association with degenerative spinal canal stenosis (Figure 1). It is believed that the acquired elongation of the nerve roots is due to a chronic compression force at the level of the lumbar spinal stenosis (LSS) 9 . This condition is not a new or separate disease but may be part of the natural evolution of lumbar canal stenosis.The recognition of RNRCE in diagnostic imaging is especially important for avoiding the misdiagnosis of other dis...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cauda equina redundant nerve roots are associated to the degree of spinal stenosis and to spondylolisthesis

Savarese

Ferreira-Neto²,

Herrero

et al. 2014

Arq. Neuro-Psiquiatr.

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“…Other radiological characteristic of spinal stenosis include the so-called redundant roots implying that on the CT-myelography or the MRI the nerve roots appear large, tortous or serpentine, and elongated (Cressman and Pawl 1968;Suzuki et al 1989). Redundant roots may develop secondary to mechanical trapping of the roots at the site of the stenosis.…”

Section: Cross-sectional Imagingmentioning

confidence: 99%

Determinants of outcome in lumbar spinal stenosis surgery

Sigmundsson¹

2014

Acta Orthopaedica

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Cover illustration: "Spine Talk", acryl paint on stretched canvas. The painting was created in 2008 by the Canadian artist Barbara C. St Jean and is a painting of two people talking to each other over top of a spine of another. The painting was created to illustrate the problems associated with back pain and the discussions with medical professionals over the causes and treatment options. By permission from the artist.

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“…[7][8][9][10][11][12] Typical findings are hypertrophy of the yellow ligament and the joint facets, the hourglass shape of the canal (in sagittal sections), and root "overcrowed". The narrowing of the canal on MRI is accepted as a good differentiating factor for canal stenosis.…”

Section: Introductionmentioning

confidence: 99%

“…The narrowing of the canal on MRI is accepted as a good differentiating factor for canal stenosis. [7][8][9][10][11][12] Although there is a wide range of clinical, electrophysiological, and radiological findings that lead us to the diagnosis, the indication for surgical treatment has still not been clearly defined, so that additional diagnostic signs are important in guiding the choice of surgery.…”

Section: Introductionmentioning

confidence: 99%

Canal lombar estreito: sinal da sedimentação

et al. 2013

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Objective: To verify the presence of the sedimentation sign in patients with lumbar spinal stenosis (LSS) in comparison to those without LSS. Methods: Retrospective, cross-sectional and descriptive study. Review of the imaging processes of patients with LSS operated between January 1, 2008 and December 31, 2009, comparing with patients without LSS observed in outpatient consultations. Patients were divided into two groups: group I had 34 patients with a diagnosis of LSS. Diagnostic criteria: existence of low back pain and/or neurogenic claudication and/or radiculopathy, associated with an anteroposterior canal diameter of less than 10 mm. Group II had 40 patients observed in outpatient consultations for low back pain without clinical LSS. The canal diameter was measured and the presence of the sedimentation sign between D12 and S1 was verified. Results: A positive sedimentation sign was identified in 31 of the 34 patients in group I (91.2%); only below the stenosis in two of these 31 patients. The sign was not observed in the patients in group II. A statistically significant correlation was observed between the variables "canal diameter" and "presence of sedimentation sign" (p < 0.01) in the group of patients with lumbar spinal stenosis. Conclusion: The diagnosis of LSS is not always easy due to the frequent dissonance between the clinical and imaging findings. The sedimentation sign is positive in patients with LSS between L1 and L5 and can be a valid sign to complement the diagnosis of LSS.Keywords: Lumbar; Roots; Diagnosis; Magnetic resonance spectroscopy; Sedimentation. RESUMO

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Serpentine Myelographic Defect Caused by a Redundant Nerve Root

Cited by 55 publications

References 1 publication

Cauda equina redundant nerve roots are associated to the degree of spinal stenosis and to spondylolisthesis

Cauda equina redundant nerve roots are associated to the degree of spinal stenosis and to spondylolisthesis

Determinants of outcome in lumbar spinal stenosis surgery

Canal lombar estreito: sinal da sedimentação

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