Jeong Ki-Soon, Cho Sung-Ae, Chung Woo-Suk, In Chi-Bum
Department of Anesthesiology and Pain Medicine.
Department of Radiology, Konyang University Hospital, Daejeon, Republic of Korea.
Medicine (Baltimore). 2020 Aug 14;99(33):e21690. doi: 10.1097/MD.0000000000021690.
The clinical outcomes of redundant nerve root syndrome (RNRS) in patients with lumbar foraminal spinal stenosis (LFSS) are currently unknown. The purpose of this study was to evaluate the postprocedural outcomes of RNRS in LFSS after percutaneous lumbar foraminoplasty (PLF) and identify the factors associated with RNRS by comparative analysis between patients with and without RNRS.Patients with LFSS who underwent PLF were retrospectively analyzed. RNRS is defined as the presence of thick, elongated, and tortuous structures in the cauda equine associated with lumbar spinal stenosis. Based on the sagittal or transverse magnetic resonance imaging scans obtained before the PLF, the patients were stratified into 2 groups. Comparative analysis was performed between patients with RNRS (group R) and those without RNRS (group C).From March 2016 to January 2019, 8 of the 21 (38.1%) patients undergoing PLF showed signs of RNRS on magnetic resonance imaging images. PLF showed a tendency for less therapeutic effect with respect to changes in pain intensity in group R as compared to group C, but there were no statistically significant differences between the 2 groups. RNRS correlated with the cross-sectional area (CSA) of the dural sac and LFSS grade (P < .05). The CSA of the dural sac was smaller and the grade of LFSS was higher in group R than in group C.RNRS is commonly associated with lumbar spinal stenosis and could affect the treatment outcomes. Clinical outcomes in group R were not statistically different from those in group C, although group R showed slightly worse outcomes. The independent factors associated with RNRS were CSA of the dural sac and the LFSS grade.
腰椎椎间孔狭窄症（LFSS）患者的冗余神经根综合征（RNRS）的临床结局目前尚不清楚。本研究的目的是评估经皮腰椎椎间孔成形术（PLF）后LFSS患者中RNRS的术后结局，并通过对有和没有RNRS的患者进行比较分析来确定与RNRS相关的因素。对接受PLF的LFSS患者进行回顾性分析。RNRS的定义是马尾神经中存在与腰椎管狭窄相关的增厚、拉长和迂曲的结构。根据PLF术前获得的矢状位或横断位磁共振成像扫描，将患者分为两组。对有RNRS的患者（R组）和无RNRS的患者（C组）进行比较分析。2016年3月至2019年1月，21例接受PLF的患者中有8例（38.1%）在磁共振成像图像上显示出RNRS的迹象。与C组相比，PLF在R组中对疼痛强度变化的治疗效果有降低的趋势，但两组之间无统计学显著差异。RNRS与硬脊膜囊的横截面积（CSA）和LFSS分级相关（P<0.05）。R组的硬脊膜囊CSA较C组小，LFSS分级较C组高。RNRS通常与腰椎管狭窄相关，并可能影响治疗结局。R组的临床结局与C组无统计学差异，尽管R组的结局略差。与RNRS相关的独立因素是硬脊膜囊的CSA和LFSS分级。
