Introduction: Three-dimensional (3D) magnetic resonance imaging (MRI) is reportedly superior to two-dimensional (2D) MRI for diagnosing lumbar foraminal stenosis at L5-S1. In this study, we strictly distinguished the intra- and extraforaminal regions and compared the diagnostic reliability and accuracy of 2D and 3D MRI in each region.
Methods: A total of 92 surgical cases of unilateral L5 radiculopathy were selected for imaging analysis, including 46 of foraminal stenosis at L5-S1 (Group F) and 46 of intraspinal canal stenosis at L4-5 (Group C) (48 men, 44 women; mean age, 66 years). The 2D and 3D MRI sets were assessed twice by two examiners. They were informed only of the laterality of the lesion in each case and asked to select among the following for each modality: "absence of foraminal stenosis," "intraforaminal stenosis," "extraforaminal stenosis," and "coincident intraforaminal and extraforaminal stenosis." The intra- and interobserver reliabilities were evaluated using kappa (κ) statistics for the intra- and extraforaminal regions and compared between 2D and 3D MRI. For each case, disagreements between examiners were resolved through discussion to obtain a diagnostic judgment for each modality. Subsequently, the final diagnosis of intra- and/or extraforaminal stenosis in Group F was made using multiple modalities and intraoperative findings. A comparison between 2D and 3D MRI in terms of diagnostic accuracy was performed for the intra- and extraforaminal regions.
Results: No significant difference was observed in the κ statistics between 2D and 3D MRI for the intraforaminal region, whereas 3D MRI had significantly larger κ statistic than 2D MRI for the extraforaminal region. Ultimately, 3D MRI perfectly judged the extraforaminal region, whereas 2D MRI detected only 44.8% of the cases of extraforaminal stenosis.
Conclusions: More than half of extraforaminal stenosis was overlooked by 2D MRI, suggesting that it is unreliable for diagnosing extraforaminal stenosis at L5-S1.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10710884 | PMC |
| http://dx.doi.org/10.22603/ssrr.2023-0110 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Shoulder Traction as a Possible Risk Factor for C5 Palsy in Anterior Cervical Surgery: A Cadaveric Study.
Medicina (Kaunas)
September 2024
Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Article Synopsis
- * It involved stretching the fifth and sixth nerve roots using varying weights on cadavers, revealing that significant stretching occurred, particularly at higher weights, with average elongations of 1.94 mm at 8 kg and 5.03 mm at 20 kg.
- * The findings suggest that shoulder traction may be a risk factor for PC5P, especially in patients with foraminal and central stenosis, highlighting the importance of informing patients about these risks prior to surgery.
Single center experience with hourglass-like constriction neuropathy of suprascapular nerve.
Muscle Nerve
November 2024
Department of Physical and Rehabilitation Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Article Synopsis
- * A retrospective review identified 14 patients with HGC of the SSN, with MRI indicating constriction primarily between the nerve's origin and the suprascapular notch, and most patients receiving non-operative treatment.
- * Findings suggest that conservative management is often effective, with significant recovery noted in the majority of patients after at least 6 months, indicating that immediate invasive treatment may not be necessary.
New ipsilateral full endoscopic interlaminar approach for L5-S1 foraminal and extraforaminal decompression: technique description and initial case series.
Neurosurg Rev
August 2024
Center for Spine Surgery and Pain Therapy, Center for Orthopaedics and Traumatology of the St. Elisabeth Group, Marien Hospital Herne, Catholic Hospital Rhein-Ruhr, St. Anna Hospital Herne, University Hospital/Marien Hospital Witten, Herne, Germany.
Background: The L5-S1 interlaminar access described in 2006 by Ruetten et al. represented a paradigm shift and a new perspective on endoscopic spinal approaches. Since then, the spinal community has shown that both the traditional ipsilateral and novel contralateral interlaminar approaches to the L5-S1 foramen are good alternatives to transforaminal access.
View Article and Find Full Text PDFUnilateral Biportal Endoscopy for L5-S1 Extraforaminal Stenosis (Far Out Syndrome) - Technical Note with Literature Review.
J Orthop Case Rep
March 2024
Yonsei Okay Hospital, Seoul, South Korea.
Introduction: Extraforaminal stenosis in L5-S1, or far-out syndrome (FOS), is defined as L5 nerve compression by the transverse process (TP) of the L5 and the ala of the sacrum and disc bulging with/without osteophytes and/or the thickened lumbosacral and extraforaminal ligament. This study aims to describe the unilateral biportal endoscopic decompression technique of the extraforaminal stenosis at L5-S1 or far out syndrome and evaluate its clinical results with a literature review.
Case Report: A 44-year-old male presented with severe right sharp shooting pain in the buttock, thigh, leg, foot, and/or toes with numbness in the foot and toes (Visual Analog Scale [VAS] 8/10) for six months with an Oswestry disability index (ODI) score of 70%.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!