Identification of abnormalities in the lumbar nerve tract using diffusion-weighted magnetic resonance neurography

Introduction Abnormalities of the lumbar nerve tract caused by congenital variations or high nerve root take-off angles are difficult to visualize. Diffusion-weighted magnetic resonance neurography (DW-MRN) has recently been introduced for imaging of the lumbosacral region. The aims of this study we...

Full description

Saved in:
Bibliographic Details
Published in:European spine journal 2019-04, Vol.28 (4), p.849-854
Main Authors: Manabe, Hiroaki, Sakai, Toshinori, Miyagi, Ryo, Tezuka, Fumitake, Yamashita, Kazuta, Takata, Yoichiro, Sairyo, Koichi
Format: Article
Language:English
Subjects:
Degeneration
Magnetic resonance imaging
Medicine
Medicine & Public Health
Neurosurgery
Original Article
Osteophytes
Pain
Sacrum
Spondylolisthesis
Surgical Orthopedics
Variation
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Introduction Abnormalities of the lumbar nerve tract caused by congenital variations or high nerve root take-off angles are difficult to visualize. Diffusion-weighted magnetic resonance neurography (DW-MRN) has recently been introduced for imaging of the lumbosacral region. The aims of this study were to identify lumbar nerve tract abnormalities caused by congenital variation or a high nerve root take-off angle using DW-MRN and to assess the diagnostic value of this imaging modality. Methods A total of 573 magnetic resonance images from 575 patients (261 men, 314 women; mean age 58.5 years) with low back/leg pain were retrospectively analyzed. We classified congenital variations in the lumbar nerve roots using the Neidre and MacNab criteria and investigated nerve roots with a take-off angle of 60° or more. Results and discussion Congenital variations were identified in 8 patients (9 nerve roots, 1.6%). The most commonly identified variation was in the sacral nerve root ( n  = 5) followed by the L4 ( n  = 3) and L5 ( n  = 1) nerve roots. All variations identified were on the left side. There were 3 cases of type 1a variation, 1 of type 1b, 1 of type 2, and 4 of type 3. In total, 210 (36.6%) of the magnetic resonance images showed high nerve root take-off angles at the intervertebral foramen that was caused by disk herniation, spondylolisthesis, or osteophytes with degeneration. Patients with high nerve root take-off angles were significantly older than those without ( P 
ISSN:0940-6719
1432-0932
DOI:10.1007/s00586-018-05867-1