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Evaluation of foraminal cross-sectional area in lumbar spondylolisthesis using kinematic MRI

European Journal of Orthopaedic Surgery & Traumatology volume 29, pages 17–23 (2019)Cite this article

Abstract

Purpose

To evaluate the kinematic change of cross-sectional area of lumbar intervertebral foramen in degenerative lumbar spondylolisthesis patients using multi-positional MRI.

Methods

Multi-positional MRI was performed on 31 patients diagnosed with single or multilevel degenerative lumbar spondylolisthesis and 31 control patients without degenerative lumbar spondylolisthesis. Foraminal area (FA) was measured at the lumbar spondylolisthesis level in degenerative lumbar spondylolisthesis group and at L3-4, L4-5, and L5-S1 level in the control group. FA was measured bilaterally in neutral, flexion, and extension positions. The difference in FA between the groups was analyzed using Mann–Whitney U test, and the difference between positions within groups was analyzed using Wilcoxon signed-rank test.

Results

Degenerative lumbar spondylolisthesis group showed significantly smaller FA on both sides and on average in all three positions compared to the control group (p < 0.05 all). From neutral to flexion position, the change in FA was significantly smaller in the degenerative lumbar spondylolisthesis group than in the control group on both sides and on average (p < 0.005 all). In degenerative lumbar spondylolisthesis group, the FA showed no significant change from neutral to flexion, but showed significant change from neutral to extension (p < 0.005 all).

Conclusions

FA in the degenerative lumbar spondylolisthesis group was smaller than in the control group. There was no difference in FA in degenerative lumbar spondylolisthesis group from neutral to flexion, only from neutral to extension. Patients with degenerative lumbar spondylolisthesis have a higher chance of developing foraminal stenosis.

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Acknowledgments

The study was supported by departmental funds. Authors would like to thank AiM Radiology Medical Group, especially to Aziza Qadir MD for the help in overseeing the upload of multi-positional MRI images into the database.

Disclosures

Disclosures outside of submitted work: ZB—Xenco Medical (consultancy), AO Spine (consultancy); JCW—Royalties—Biomet, Seaspine, Amedica, DePuy Synthes; Investments/Options—Fziomed, Promethean, Paradigm Spine, Benvenue, Nexgen, Vertiflex, Electrocore, Surgitech, Expanding Orthopedics, Osprey, Bone Biologics, Pearldiver; Board of Directors—North American Spine Society (non-financial, reimbursement for travel for board meetings, courses etc.), North American Spine Foundation (non-financial), AO Foundation (financial, $20,000 honorariums for board positions, plus travel for board meetings), Cervical Spine Research Society (non-financial, reimbursement for travel for board meetings); Editorial Boards—Spine, JAAOS, The Spine Journal, Clinical Spine Surgery, Global Spine Journal; Fellowship Funding (paid to institution): AO Foundation. Yusuf A. Khan, Sameer U. Khan—family relationships (a family member owner of kMRI imaging center).

Author information

Affiliations

  1. Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1450 Biggy Street, NRT-2509N, Mail Code: 9601, Los Angeles, CA, 90033, USA

    Permsak Paholpak, Alexander Nazareth, Koji Tamai, Zorica Buser & Jeffrey C. Wang

  2. Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

    Permsak Paholpak

  3. AiM Radiology Medical Group, Bellflower, USA

    Yusuf A. Khan, Sameer U. Khan & Faisal Ansari

  4. Department of Orthopedics, Osaka City University Graduate School of Medicine, Osaka, Japan

    Koji Tamai

Authors
  1. Permsak Paholpak
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  2. Alexander Nazareth
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  3. Yusuf A. Khan
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  6. Koji Tamai
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Correspondence to Zorica Buser.

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No conflict of interest for the current study.

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Paholpak, P., Nazareth, A., Khan, Y.A. et al. Evaluation of foraminal cross-sectional area in lumbar spondylolisthesis using kinematic MRI. Eur J Orthop Surg Traumatol 29, 17–23 (2019). https://doi.org/10.1007/s00590-018-2276-x

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  • DOI: https://doi.org/10.1007/s00590-018-2276-x

Keywords

  • Degenerative spondylolisthesis
  • Lumbar spondylolisthesis
  • Foramina area
  • Foraminal stenosis
  • Degenerative lumbar
  • Multi-positional MRI