Radiological significance of ligamentum flavum hypertrophy in the occurrence of redundant nerve roots of central lumbar spinal stenosis

Junseok W. Hur, Junho K. Hur, Taek-Hyun Kwon, Youn-Kwan Park, Hung Seob Chung, Joo-Han Kim

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: There were previous reports of redundant nerve roots (RNRs) focused on their clinical significance and pathogenesis. In this study, we investigated the signific radiologic findings that correlate with RNRs occurrence. These relations would provide an advanced clue for clinical signifcance and pathogenesis of RNRs. Methods: Retrospective research was performed with data from 126 patients who underwent surgery for central lumbar spinal stenosis (LSS). Finally, 106 patients with common denominators (inter-observer accuracy: 84%) were included on this study. We divided the patients into two groups by MRI, patients with RNRs and those with no RNRs (NRNRs). Comparative analyses were performed with clinical and radiologic parameters. Results: RNRs were found in 45 patients (42%) with central LSS. There were no statistically signific differences between the two groups in severity of symptoms. On the other hand, we found statistically signific differences in duration of symptom and number of level included (p<0.05). In the maximal stenotic level, ligamentum favum (LF) thickness, LF cross-sectional area (CSA), dural sac CSA, and segmental angulation are significantly different in RNRs group compared to NRNRs group (p<0.05). Conclusion: RNRs patients showed clinically longer duration of symptoms and multiple levels included. We also confirmed that wide segmental angulation and LF hypertrophy play a major role of the development of RNRs in central LSS. Together, our results suggest that wide motion in long period contribute to LF hypertrophy, and it might be the key factor of RNRs formation in central LSS.

Original languageEnglish
Pages (from-to)215-220
Number of pages6
JournalJournal of Korean Neurosurgical Society
Volume52
Issue number3
DOIs
Publication statusPublished - 2012 Sep 1

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Ligamentum Flavum
Spinal Stenosis
Hypertrophy
Research

Keywords

  • Central lumbar spinal stenosis
  • Ligamentum favum hypertrophy
  • Redundant nerve roots

ASJC Scopus subject areas

  • Surgery
  • Neuroscience(all)
  • Clinical Neurology

Cite this

Radiological significance of ligamentum flavum hypertrophy in the occurrence of redundant nerve roots of central lumbar spinal stenosis. / Hur, Junseok W.; Hur, Junho K.; Kwon, Taek-Hyun; Park, Youn-Kwan; Chung, Hung Seob; Kim, Joo-Han.

In: Journal of Korean Neurosurgical Society, Vol. 52, No. 3, 01.09.2012, p. 215-220.

Research output: Contribution to journalArticle

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abstract = "Objective: There were previous reports of redundant nerve roots (RNRs) focused on their clinical significance and pathogenesis. In this study, we investigated the signific radiologic findings that correlate with RNRs occurrence. These relations would provide an advanced clue for clinical signifcance and pathogenesis of RNRs. Methods: Retrospective research was performed with data from 126 patients who underwent surgery for central lumbar spinal stenosis (LSS). Finally, 106 patients with common denominators (inter-observer accuracy: 84{\%}) were included on this study. We divided the patients into two groups by MRI, patients with RNRs and those with no RNRs (NRNRs). Comparative analyses were performed with clinical and radiologic parameters. Results: RNRs were found in 45 patients (42{\%}) with central LSS. There were no statistically signific differences between the two groups in severity of symptoms. On the other hand, we found statistically signific differences in duration of symptom and number of level included (p<0.05). In the maximal stenotic level, ligamentum favum (LF) thickness, LF cross-sectional area (CSA), dural sac CSA, and segmental angulation are significantly different in RNRs group compared to NRNRs group (p<0.05). Conclusion: RNRs patients showed clinically longer duration of symptoms and multiple levels included. We also confirmed that wide segmental angulation and LF hypertrophy play a major role of the development of RNRs in central LSS. Together, our results suggest that wide motion in long period contribute to LF hypertrophy, and it might be the key factor of RNRs formation in central LSS.",
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AB - Objective: There were previous reports of redundant nerve roots (RNRs) focused on their clinical significance and pathogenesis. In this study, we investigated the signific radiologic findings that correlate with RNRs occurrence. These relations would provide an advanced clue for clinical signifcance and pathogenesis of RNRs. Methods: Retrospective research was performed with data from 126 patients who underwent surgery for central lumbar spinal stenosis (LSS). Finally, 106 patients with common denominators (inter-observer accuracy: 84%) were included on this study. We divided the patients into two groups by MRI, patients with RNRs and those with no RNRs (NRNRs). Comparative analyses were performed with clinical and radiologic parameters. Results: RNRs were found in 45 patients (42%) with central LSS. There were no statistically signific differences between the two groups in severity of symptoms. On the other hand, we found statistically signific differences in duration of symptom and number of level included (p<0.05). In the maximal stenotic level, ligamentum favum (LF) thickness, LF cross-sectional area (CSA), dural sac CSA, and segmental angulation are significantly different in RNRs group compared to NRNRs group (p<0.05). Conclusion: RNRs patients showed clinically longer duration of symptoms and multiple levels included. We also confirmed that wide segmental angulation and LF hypertrophy play a major role of the development of RNRs in central LSS. Together, our results suggest that wide motion in long period contribute to LF hypertrophy, and it might be the key factor of RNRs formation in central LSS.

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