Influence of anatomical variations on lumbar foraminal stenosis pathogenesis.

Détails

ID Serval
serval:BIB_55AC707DFC96
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Influence of anatomical variations on lumbar foraminal stenosis pathogenesis.
Périodique
European Spine Journal
Auteur⸱e⸱s
Merckaert S., Pierzchala K., Kulik G., Schizas C.
ISSN
1432-0932 (Electronic)
ISSN-L
0940-6719
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
24
Numéro
2
Pages
313-318
Langue
anglais
Notes
Publication types: Journal Article Publication Status: ppublish
Résumé
INTRODUCTION: Symptomatic foraminal stenosis has been observed in patients with degenerative disc disease, scoliosis, asymmetrical disc degeneration and spondylolisthesis. Nevertheless not all patients with the above pathologies will develop symptomatic foraminal stenosis. We hypothesised that symptomatic patients have anatomical predisposition to foraminal stenosis, namely a larger pedicle height (PH) to vertebral body height (VH) ratio, leaving less room below the pedicle for the exiting nerve root compared to asymptomatic patients.
PATIENT SAMPLE: 66 Patients were divided in two groups. The surgical group consisted of 37 patients (average age of 61 years) who presented with severe radicular symptoms resisting to conservative measures and requiring decompression and transforaminal lumbar interbody fusion (TLIF). The control group consisted of 29 patients (average age of 51 years) presenting with low back pain (LBP) but with no radicular symptoms and who were treated conservatively.
METHODS: We measured VH at the level of the posterior wall as well as PH on parasagittal images (CT or MRI) on all lumbar levels (L1 to L5). Statistical analysis was performed using Student's t test.
RESULTS: No difference in PH was found between the two groups for L1 to L4 levels. By contrast, there was a highly statistically significant difference in VH between the two groups from L1 to L4 level. In the surgical group, the VH was smaller (p < 0.001).
CONCLUSIONS: Symptomatic patients with foraminal stenosis have smaller VH leading to lesser space beneath the pedicle and putting the exiting nerve root at risk in cases of spondylolisthesis or disc degeneration.
Pubmed
Web of science
Création de la notice
13/03/2015 19:43
Dernière modification de la notice
09/04/2020 6:26
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