title: Morphometric analysis of the lumbar intervertebral foramen in patients with degenerative lumbar scoliosis by multidetector-row computed tomography.
abstract: OBJECTIVE
  How the lumbar neural foramina are affected by segmental deformities in patients in whom degenerative lumbar scoliosis (DLS) is unknown. Here, we used multidetector-row computed tomography (MDCT) to measure the morphology of the foramina in three dimensions, which allowed us to elucidate the relationships between foraminal morphology and segmental deformities in DLS.
  
  
  METHODS
  In 77 DLS patients (mean age, 69.4) and 19 controls (mean age, 69), the foraminal height (FH), foraminal width (FW), posterior disc height (PDH), interval between the pedicle and superior articular process (P-SAP), and cross-sectional foraminal area (FA) were measured on reconstructed MDCT data, using image-editing software, at the entrance, minimum-area point, and exit of each foramen. The parameters of segmental deformity included the intervertebral wedging angle and anteroposterior and lateral translation rate, measured on radiographs, and the vertebral rotation angle, measured using reconstructed MDCT images.
  
  
  RESULTS
  The FH, PDH, P-SAP, and FA were smaller at lower lumbar levels and on the concave side of intervertebral wedging (p < 0.05). In the DLS patients, the FH, P-SAP, and FA were significantly smaller than for the control group at all three foraminal locations and every lumbar level (p < 0.05). Intervertebral wedging strongly decreased the FA of the concave side (p < 0.05). Anteroposterior translation caused the greatest reduction in P-SAP (p < 0.05). Vertebral rotation decreased the P-SAP and FA at the minimum-area point on the same side as the rotation (p < 0.05).
  
  
  CONCLUSIONS
  The new analysis method proposed here is useful for understanding the pathomechanisms of foraminal stenosis in DLS patients.
authors: Department of Orthopaedic Surgery, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo 160-8582, Japan.
authors: Yasuhito
authors: Y
authors: Kaneko
authors: Morio
authors: M
authors: Matsumoto
authors: Hironari
authors: H
authors: Takaishi
authors: Yuji
authors: Y
authors: Nishiwaki
authors: Suketaka
authors: S
authors: Momoshima
authors: Yoshiaki
authors: Y
authors: Toyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007403:Intervertebral Disc / Q000000981:diagnostic imaging*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D011856:Radiographic Image Enhancement; D012600:Scoliosis / Q000000981:diagnostic imaging*