Morphologic Changes of L5 Root at Coronal Source Images of MR Myelography in Cases of Foraminal or Extraforaminal Compression.
OBJECTIVE
TWO FINDINGS EASILY FOUND AT CORONAL SOURCE IMAGES OF MR MYELOGRAPHY (MRM) WERE EVALUATED : dorsal root ganglion (DRG) swelling and running course abnormality (RCA) of L5 exiting root at foramen or extraforamen. We tried to find the sensitivity of each finding when root was compressed.


METHODS
From 2004 July to 2006, one hundred and ten patients underwent one side paraspinal decompression for their L5 root foraminal or extraforaminal compression at L5-S1 level. All kinds of conservative treatments failed to improve leg symptom for several months. Before surgery, MRI, CT and MRM were done. Retrospective radiologic analysis for their preoperative MRM coronal source images was done to specify root compression sites and L5 root morphologic changes.


RESULTS
DRG swelling was found in 66 (60%) of 110 patients. DRG swelling has statistically valuable meaning in foraminal root compression (chi-square test, p < 0.0001). Seventy-two (66%) in 110 patients showed abnormal alteration of running course. Abnormal running course has statistically valuable meaning in foraminal or extraforaminal root compression (chi-square test, p < 0.0001).


CONCLUSIONS
Three-dimensional MRM provides precise thin sliced coronal images which are most close to real operative views. DRG swelling and running course abnormality of L5 exiting root are two useful findings in diagnosing L5 root compression at L5-S1 foramen or extraforamen. MRM is thought to provide additional diagnostic accuracy expecially in L5-S1 foraminal and extraforaminal area.
Kim
Soo-Beom
SB
Department of Orthopedic Surgery, Seoul Wooridul Hospital, Seoul, Korea.
Jang
Jee-Soo
JS
Lee
Sang-Ho
SH
Spine (Phila Pa 1976). 2005 Aug 1;30(15):1712-6
16094271
AJNR Am J Neuroradiol. 2006 Nov-Dec;27(10):2098-103
17110675
Spine (Phila Pa 1976). 1993 Nov;18(15):2246-51
8278840
Spine (Phila Pa 1976). 2002 Mar 15;27(6):E169-73
11884922
Spine (Phila Pa 1976). 2007 Apr 15;32(8):896-903
17426636
Neurosurgery. 1994 Apr;34(4):643-7; discussion 648
8008161
Spine (Phila Pa 1976). 1998 Dec 1;23(23):2538-44
9854752
Spine (Phila Pa 1976). 1989 Jun;14(6):569-73
2546258
Spine (Phila Pa 1976). 1984 Jan-Feb;9(1):31-41
6719255
Acta Neurochir (Wien). 1997;139(11):1080-4
9442224
Int Orthop. 1982;6(3):197-202
7166449
Spine (Phila Pa 1976). 1991 Mar;16(3):336-47
2028306
Clin Orthop Relat Res. 1981 Jun;(157):191-9
7249453
J Comput Assist Tomogr. 1986 May-Jun;10(3):375-8
3700736
Clin Orthop Relat Res. 1997 Jul;(340):230-5
9224261
Spine (Phila Pa 1976). 2003 Mar 1;28(5):423-8; discussion 427-8
12616150