J Korean Neurosurg Soc.  2010 Jan;47(1):1-6. 10.3340/jkns.2010.47.1.1.

The Role of Computed Tomography in the Presurgical Diagnosis of Foraminal Entrapment of Lumbosacral Junction

• Moon KH
• Jang JS
• Lee SH
• Lee SC
• Lee HY

• KMID: 1495081
• DOI: http://doi.org/10.3340/jkns.2010.47.1.1

Abstract

OBJECTIVE
On the basis of preoperative computed tomography (CT) scans, we studied the change of the size of anterior primary division (APD) of the L5 spinal root in the presence of foraminal/extraforaminal entrapment of the L5 spinal root.
METHODS
Two independent radiologists retrospectively reviewed the preoperative CT scans of 27 patients treated surgically and compared the sizes of the APDs on bilateral L5 spinal roots. If one side APD size was larger than the other side APD size, it was described as left or right "dominancy" and regarded this as "consensus (C)" in case that there was a consensus between the larger APD and the location of sciatica, and regarded as "non-consensus (NC)" in case that there was not a consensus. Oswestry Disability Index (ODI) scores were used for preoperative and postoperative evaluation.
RESULTS
On CT scans, twenty-one (77%) of 27 patients were the consensus group (APD swelling) and 6 (22%) were a non-consensus group (APD no swelling). In 9 patients with acute foraminal disc herniations, asymmetric enlargement of the APD on L5 spinal root was detected in all cases (100%) and detected in 11 (64%) of 17 patients with stenosis. Preoperative ODI score was 75-93 (mean 83) and postoperative ODI scores were improved to 13-36 (mean 21). The mean follow-up period was 6 months (range, 3-11 months).
CONCLUSION
An asymmetric enlargement of the APD on L5 spinal root on CT scans is meaningfully associated with a foraminal or extraforaminal entrapment of the L5 spinal root on the lumbosacral junction.

Keyword

Computed tomography; Foraminal-extraforaminal entrapment; Lumbosacral junction; Radiculopathy; Surgery

MeSH Terms

Consensus
Constriction, Pathologic
Diphosphonates
Follow-Up Studies
Humans
Radiculopathy
Retrospective Studies
Sciatica
Spinal Nerve Roots
Diphosphonates