Brief review 1
*Title: Does the presence of the nerve root sedimentation sign on MRI correlate with the operative level in patients undergoing posterior lumbar decompression for lumbar stenosis?
*Authors: Akil Fazal, MD, Andrew Yoo, BA, John A. Bendo, MD
*Bibliography: Spine J. 2013 Aug;13(8):837-42.
-Recent research describes the use of a nerve root sedimentation sign to diagnose lumbar spinal stenosis (LSS).
-The lack of sedimentation of the nerve roots (positive sedimentation sign) to the dorsal part of the dural sac is the characteristic feature of this new radiological parameter.
PURPOSE: To demonstrate how the nerve root sedimentation sign compares with other more traditional radiological parameters in patients who have been operated for LSS.
STUDY DESIGN/SETTING: A retrospective chart and image review.
PATIENT SAMPLE: Preoperative MRI were reviewed from 71 consecutive operative patients who presented with LSS and received spinal decompression surgery (2006-2010).
OUTCOME MEASURES: Preoperative T2-weighted MRIs were reviewed for each patient.
134 vertebral levels (L1-5) were measured for
1) sedimentation sign
2) cross-sectional area (CSA)
3) anterior/posterior (A/P) diameter of the dural sac
4) thickness of the ligamentum flavum
5) Fujiwara grade of facet hypertrophy.
-using Surgimap 18.104.22.168 software (Nemaris, Inc., New York, NY, USA)
-Exclusion criteria: 1) previous spine surgeries 2) absence of MRI on extended dynamic range 3) surgeries for primary diagnosis other than LSS
-using the SPSS 17.0 statistical software (SPSS Inc., Chicago, IL, USA).
-Significance was demonstrated using unpaired t tests and chi-squared tests.
RESULTS: The measurements are listed below.
-The sign is most often present in patients who have clinically significant lumbar stenosis and require surgery.
-The sedimentation sign is a new measurement tool that can enable physicians to objectively assess and quantify spinal stenosis.
*Fujiwara grading system: aim to assess the severity of the facet joint osteoarthritis.