title: Characteristics of nerve root compression caused by degenerative lumbar spinal stenosis with scoliosis.
abstract: BACKGROUND
  In degenerative lumbar spinal stenosis with scoliosis (DLS), many authors stated that nerve root compression is almost always seen on the concave side of the scoliosis, and L4 and L5 nerve roots are the most often involved. However, there are few reports on the relationship between nerve root compression and the pattern of scoliosis.
  
  
  OBJECTIVE
  To investigate the factors that may contribute to radiculopathy in DLS and their association with the pattern of the scoliosis.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  Twenty-two consecutive patients with DLS with radiculopathy were examined. The symptomatic nerve roots were determined by pain distribution, neurological findings and nerve root infiltration using lidocaine. The compressive factors were diagnosed by magnetic resonance imaging or myelography, discography, computed tomography after myelography or discography and radiculography. The pattern of scoliosis was determined in plain radiographs. We evaluated the correlation between the affected nerve root and the compressive factors or the pattern of the scoliosis.
  
  
  RESULTS
  The L3 root was affected in 23% of patients; L4 root in 68%, L5 root in 55% and S1 root in 18%. L3 and L4 roots were more compressed by foraminal or extraforaminal stenosis on the concave side of the curve, whereas L5 and S1 roots were commonly affected by lateral recess stenosis on the convex side. The Cobb angle and the lateral slip of the cases in which L3 or L4 root was affected were significantly larger than in cases in which L5 or S1 root was compressed.
  
  
  CONCLUSIONS
  In the treatment of radiculopathy caused by DLS, it is important to bear in mind that L3 or L4 roots were more strongly compressed by foraminal or extraforaminal stenosis at the concave side of the curve, whereas L5 or S1 nerve roots were affected more by lateral recess stenosis at the convex side of the curve.
authors: Department of Orthopaedic Surgery, Toyama Medical and Pharmaceutical University, Toyama, Japan.
authors: Hong
authors: H
authors: Liu
authors: Hirokazu
authors: H
authors: Ishihara
authors: Masahiko
authors: M
authors: Kanamori
authors: Yoshiharu
authors: Y
authors: Kawaguchi
authors: Kazuo
authors: K
authors: Ohmori
authors: Tomoatsu
authors: T
authors: Kimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D009192:Myelography; D011843:Radiculopathy / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D018570:Risk Assessment; D012600:Scoliosis / Q000150:complications* / Q000000981:diagnostic imaging; D012720:Severity of Illness Index; D013130:Spinal Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome