Differentiation between Symptomatic and Asymptomatic Extraforaminal Stenosis in Lumbosacral Transitional Vertebra: Role of Three-Dimensional Magnetic Resonance Lumbosacral Radiculography

• Published in: Korean journal of radiology Vol. 13; no. 4; pp. 403 - 411
• Main Authors: Byun, Woo Mok, Kim, Jae Woon, Lee, Jae Kyo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Radiology 01.07.2012; 대한영상의학회
• Subjects: Aged; Aged, 80 and over; Asymptomatic; Back pain; Contrast Media; Diagnosis, Differential; Female; Humans; Imaging, Three-Dimensional; Lumbosacral Region - pathology; Magnetic Resonance Imaging - methods; Male; Medical imaging; Middle Aged; Nerve Compression Syndromes - diagnosis; Nerve Compression Syndromes - pathology; Original; Osteophyte - pathology; Spinal Stenosis - diagnosis; Spinal Stenosis - pathology; Surgery; Vertebrae; 방사선과학; MRI; Spinal nerve root; Extraforaminal stenosis
• ISSN: 1229-6929; 2005-8330; 2005-8330
• DOI: 10.3348/kjr.2012.13.4.403

To investigate the role of lumbosacral radiculography using 3-dimentional (3D) magnetic resonance (MR) rendering for diagnostic information of symptomatic extraforaminal stenosis in lumbosacral transitional vertebra. The study population consisted of 18 patients with symptomatic (n = 10) and asymptomatic extraforaminal stenosis (n = 8) in lumbosacral transitional vertebra. Each patient underwent 3D coronal fast-field echo sequences with selective water excitation using the principles of the selective excitation technique (Proset imaging). Morphologic changes of the L5 nerve roots at the symptomatic and asymptomatic extraforaminal stenosis were evaluated on 3D MR rendered images of the lumbosacral spine. Ten cases with symptomatic extraforaminal stenosis showed hyperplasia and degenerative osteophytes of the sacral ala and/or osteophytes at the lateral margin of the L5 body. On 3D MR lumbosacral radiculography, indentation of the L5 nerve roots was found in two cases, while swelling of the nerve roots was seen in eight cases at the exiting nerve root. Eight cases with asymptomatic extraforaminal stenosis showed hyperplasia and degenerative osteophytes of the sacral ala and/or osteophytes at the lateral margin of the L5 body. Based on 3D MR lumbosacral radiculography, indentation or swelling of the L5 nerve roots was not found in any cases with asymptomatic extraforaminal stenosis. Results from 3D MR lumbosacral radiculography Indicate the indentation or swelling of the L5 nerve root in symptomatic extraforaminal stenosis. Based on these findings, 3D MR radiculography may be helpful in the diagnosis of the symptomatic extraforaminal stenosis with lumbosacral transitional vertebra.