Ono Atsushi, Suetsuna Futoshi, Irie Tomoyuki, Yokoyama Toru, Numasawa Takuya, Wada Kanichiro, Toh Satoshi
Department of Orthopaedic Surgery, Hirosaki University School of Medicine, Japan.
J Neurosurg Spine. 2007 Jul;7(1):27-32. doi: 10.3171/SPI-07/07/027.
Previous reports of redundant nerve roots (RNRs) of the cauda equina have been limited to evaluations based on myelography. Neither the imaging nor the clinical features of RNRs in relation to magnetic resonance (MR) imaging have been elaborated. The MR imaging characteristics of RNRs were evaluated using the Japanese Orthopaedic Association score before and after the surgery.
There were 44 patients with L4-5 spondylolisthesis in which a complete blockage was demonstrated on myelography. All patients underwent posterior L4-5 interbody fusion. Based the myelographic and MR imaging findings, the patients were stratified into the following three groups: RNRs recognized on both myelographic and MR imaging (Group A); RNRs recognized on myelography but not very evident on MR imaging (Group B); and RNRs not recognized on either myelographic or MR imaging (Group C). Among these three groups, pre- and postoperative clinical symptoms were compared.
There were 16 patients in Group A, 14 in Group B, and 14 in Group C. In terms of preoperative clinical symptoms, there was a significant difference between Groups A and C in the incidence of leg pain and tingling sensation. Significant differences were also noted between Groups A and C and between Groups B and C in ambulatory ability. Evaluation of postoperative clinical symptoms showed a significant difference between Groups A and C in ambulatory ability.
Patients with MR imaging evidence of RNRs presented with more severe clinical symptoms. It is believed that the RNR features derived from MR images represent important findings.
以往关于马尾神经冗余神经根（RNRs）的报道仅限于基于脊髓造影的评估。尚未详细阐述RNRs与磁共振（MR）成像相关的影像学及临床特征。使用日本矫形外科学会评分评估手术前后RNRs的MR成像特征。
44例L4-5椎体滑脱患者，脊髓造影显示完全梗阻。所有患者均接受L4-5后路椎间融合术。根据脊髓造影和MR成像结果，将患者分为以下三组：脊髓造影和MR成像均显示RNRs（A组）；脊髓造影显示RNRs但在MR成像上不明显（B组）；脊髓造影和MR成像均未显示RNRs（C组）。比较这三组患者术前和术后的临床症状。
A组16例，B组14例，C组14例。术前临床症状方面，A组和C组在腿痛和刺痛感发生率上存在显著差异。A组和C组之间以及B组和C组之间在行走能力方面也存在显著差异。术后临床症状评估显示，A组和C组在行走能力方面存在显著差异。
有MR成像证据显示存在RNRs的患者临床症状更严重。认为MR图像显示的RNRs特征代表重要发现。
