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Redundant nerve roots indicate higher degree of stenosis in lumbar spine stenotic patients

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Abstract

Objectives

Redundant Nerve Root (RNR) is a tortuous and elongated radiological appearance of cauda equina on Magnetic Resonance Imaging (MRI) in Lumbar Spinal Canal Stenosis (LSCS) patients. This study evaluated preoperative spinal morphometry associated with the development of RNR.

Methods

The retrospective cohort was conducted at The Aga Khan University Hospital, and included patients undergoing decompressive spinal surgery secondary to degenerative LSCS in 2015. The patients were divided into two groups with respect to the presence of preoperative RNR. Spinal morphometry was defined by several radiological parameters, including areas of dural sac (DSA), spinal canal, spinal foramen, facets, and spinal joints, and bilateral angles based on vertebral anatomy.

Results

A total of 55 patients were enrolled with a mean age of 57.1 years, in which 22 (40%) expressed RNR in their MRI. The RNR group had significantly lower mean DSA (59.64 vs 84.01 mm2; p = 0.028), bilateral posterior facet angle (Right: 33.84 vs 46.21, p = 0.004; Left: 36.43 vs 43.80, p = 0.039) and higher bilateral anterior facet angles (Right: 54.85 vs 44.57, p = 0.026; Left: 55.27 vs 46.36, p = 0.050) compared to the non-RNR group. The other bidimensional and angular parameters did not observe any statistical difference between the two groups.

Conclusion

RNR was associated with a higher degree of stenosis in patients with LSCS. Bilateral anterior and posterior facets angles contribute to its development, indicating particular spinal morphology to be vulnerable to the stenotic disease.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Section of Neurosurgery, Department of Surgery, The Aga Khan University, Karachi, Pakistan

    Karim Rizwan Nathani, Hamid Hussain Rai, Komal Naeem & Syed Ather Enam

  2. Department of Radiology, The Aga Khan University, Karachi, Pakistan

    Muhammad Danish Barakzai & Fatima Mubarak

  3. Section of ENT, Department of Surgery, The Aga Khan University, Karachi, Pakistan

    Haissan Iftikhar

  4. Section of Neurosurgery, Department of Surgery, The Liaquat National Hospital, Stadium Road, Karachi, 74800, Pakistan

    Saad Akhtar Khan

Authors
  1. Karim Rizwan Nathani
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  2. Muhammad Danish Barakzai
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  3. Hamid Hussain Rai
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  4. Komal Naeem
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  5. Fatima Mubarak
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  6. Haissan Iftikhar
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  7. Saad Akhtar Khan
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  8. Syed Ather Enam
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Correspondence to Saad Akhtar Khan.

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Ethical approval and Informed consent

The study was performed following approval of the institutional ethics review committee and in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Individual patient consent was not required as no identifying information was presented in the study.

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Nathani, K.R., Barakzai, M.D., Rai, H.H. et al. Redundant nerve roots indicate higher degree of stenosis in lumbar spine stenotic patients. Acta Neurol Belg 123, 1781–1787 (2023). https://doi.org/10.1007/s13760-022-02040-w

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  • DOI: https://doi.org/10.1007/s13760-022-02040-w

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