title: [Radiological characteristics and clinical manifestation of isolated lumbar foraminal stenosis].
abstract: OBJECTIVE
  To discuss radiological characteristics and clinical manifestation of isolated lumbar foraminal stenosis.
  
  
  METHODS
  From March 2011 to March 2014, 21 patients with isolated degenerative lumbar foraminal stenosis accepted lumbar decompression and fusion in Beijing Luhe Hospital. Intervertebral disc space was evaluated by measuring the position of joint-body line on preoperative X-ray. Bilateral foraminal area of the corresponding segment in CT (sagittal view of 2D reconstruction) and MRI (T2W1 sagittal view) were measured by Surgimap software. For patients with unilateral symptoms, foraminal area of the affected side was compared with that of the contralateral side. Foraminal area of the same segment on CT was also compared with that on MRI. Preoperatively and at the final follow-up, visual analogue score (VAS) and Oswestry Disability Index (ODI) were used to evaluate clinical outcomes.
  
  
  RESULTS
  All patients had a follow-up over 6 months and the average follow-up was 16.8 months (7-42 months). Of the 21 patients (26 segments), 12 segments showed gross narrowing and 14 segments showed slight narrowing. After preoperative measurement on MRI, 6 patients had foraminal stenosis of grade 2, and 15 patients had foraminal stenosis of grade 3, showing no significant difference in clinical outcomes. Compared with the foraminal area of the unaffected side, the affected side showed a decrease of 16% on CT and 28% on MRI, and the difference was statistically significant (t = 3.453, P < 0.05). The foraminal area measured on CT was larger than that measured on MRI (P < 0.05). Compared with that preoperatively, VAS (back pain), VAS (leg pain) and ODI showed significant improvement at the final follow-up (P < 0.05).
  
  
  CONCLUSIONS
  Radiological examinations as X-ray, CT, MRI and intervertebral foramen block technique play an important role in the diagnosis of foraminal stenosis. Soft oppression caused by hyperplasia and hypertrophy of transforaminal ligment or joint capsule may be important promoters of degenerative lumbar foraminal stenosis. Lumbar foraminal decompression and interbody fusion can satisfactorily improve preoperative symptoms.
authors.affiliation: Department of Orthopedics, Beijing Luhe Hospital, Capital Medical University, Beijing 100020, China.
authors.forename: Xueming
authors.initials: X
authors.lastname: Chen
authors.affiliation: Email: fengsq@hotmail.com.
authors.forename: Shiqing
authors.initials: S
authors.lastname: Feng
authors.forename: Hua
authors.initials: H
authors.lastname: Guan
authors.forename: Zhenshan
authors.initials: Z
authors.lastname: Yu
authors.forename: Libin
authors.initials: L
authors.lastname: Cui
authors.forename: Yanhui
authors.initials: Y
authors.lastname: Wang
authors.forename: Songjie
authors.initials: S
authors.lastname: Xu
authors.forename: Xin
authors.initials: X
authors.lastname: Yuan
mesh_terms: D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D019299:Decompression, Surgical; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery*; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D013123:Spinal Fusion; D013130:Spinal Stenosis / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed