Qian Jingli, Liang Kaiwen, Luo Xianping, Ying Caiyun
Department of Traditional Chinese Medicine and Rehabilitation, People's Hospital of Chongqing Liangjiang New Area, Chongqing, China.
Department of Health Management Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Front Neurol. 2024 May 27;15:1385770. doi: 10.3389/fneur.2024.1385770. eCollection 2024.
To observe changes in the cauda equina nerve on lumbar MRI in patients with central lumbar spinal stenosis (LSS).
878 patients diagnosed with LSS by clinical and MRI were divided into the redundant group (204 patients) and the nonredundant group (674 patients) according to the presence or absence of redundant nerve roots (RNRs). The anteroposterior diameter of the spinal canal (APDS) and the presence of multiple level stenosis, disc herniation, thickening of ligamentum flavum (LF) and increased epidural fat were assessed on MRI. Univariate and multivariate logistic regression analyses were performed to explore the predictors of LSS combined with RNRs.
Patients with LSS combined with RNRs had thicker epidural fat, smaller APDS and more combined multifaceted stenosis. Female patients and older LSS patients were more likely to develop RNRs; there was no difference between two groups in terms of disc herniation ( > 0. 05). Age, APDS, multiple level stenosis, and increased epidural fat were significantly correlated with the formation of LSS combined with RNRs ( < 0.05).
A smaller APDS and the presence of multiple level stenosis, thickening of LF, and increased epidural fat may be manifestations of anatomical differences in patients with LSS combined with RNRs. Age, APDS, multiple level stenosis, and increased epidural fat play important roles. The lumbar spine was measured and its anatomy was observed using multiple methods, and cauda equina changes were assessed to identify the best anatomical predictors and provide new therapeutic strategies for the management of LSS combined with RNRs.
观察中央型腰椎管狭窄症（LSS）患者腰椎MRI上马尾神经的变化。
878例经临床及MRI诊断为LSS的患者，根据是否存在神经根冗余（RNRs）分为冗余组（204例）和非冗余组（674例）。在MRI上评估椎管前后径（APDS）以及多节段狭窄、椎间盘突出、黄韧带（LF）增厚和硬膜外脂肪增多的情况。进行单因素和多因素逻辑回归分析，以探索LSS合并RNRs的预测因素。
LSS合并RNRs的患者硬膜外脂肪更厚，APDS更小，合并多节段狭窄更多。女性患者和年龄较大的LSS患者更易出现RNRs；两组间椎间盘突出情况无差异（P>0.05）。年龄、APDS、多节段狭窄和硬膜外脂肪增多与LSS合并RNRs的形成显著相关（P<0.05）。
较小的APDS以及多节段狭窄、LF增厚和硬膜外脂肪增多可能是LSS合并RNRs患者解剖学差异的表现。年龄、APDS、多节段狭窄和硬膜外脂肪增多起重要作用。采用多种方法测量腰椎并观察其解剖结构，评估马尾神经变化，以确定最佳解剖学预测因素，并为LSS合并RNRs的治疗提供新策略。
