Related Experiment Videos
Isthmic lumbar spondylolisthesis with sciatica. MR imaging vs myelography
M Annertz1, S Holtås, S Cronqvist
1Department of Diagnostic Radiology, University Hospital, Lund, Sweden.
Acta Radiologica (Stockholm, Sweden : 1987)
|September 1, 1990
Summary
Magnetic resonance (MR) imaging effectively identified nerve compression in patients with sciatica and lumbar spondylolisthesis. MR imaging revealed foraminal stenosis and pedicular kinking, often missed by myelography.
Area of Science:
- Orthopedics
- Radiology
- Neurosurgery
Background:
- Sciatica and isthmic lumbar spondylolisthesis are common causes of low back pain.
- Accurate diagnosis of nerve root compression is crucial for effective treatment.
Purpose of the Study:
- To evaluate the utility of magnetic resonance (MR) imaging in diagnosing nerve compression in patients with sciatica and isthmic lumbar spondylolisthesis.
- To compare MR imaging findings with myelography and surgical outcomes.
Main Methods:
- Seventeen patients with sciatica and isthmic lumbar spondylolisthesis underwent MR imaging.
- Thirteen patients also had myelography.
- Surgical findings were correlated with imaging results.
Main Results:
- MR imaging revealed altered neural foramen shape in all cases, with varying degrees of nerve compression (n=16) or identification difficulty (n=9).
- Foraminal stenosis severity correlated with unilateral sciatica symptoms.
- Pedicular kinking was observed on coronal MR views.
- Eight patients underwent surgery, confirming MR findings of nerve compression by fibrous tissue and pedicular kinking.
- Myelography provided incomplete information due to peripheral compression sites.
Conclusions:
- MR imaging is a valuable tool for diagnosing nerve compression in sciatica associated with lumbar spondylolisthesis.
- MR imaging offers superior visualization of neural foramina and peripheral nerve compression compared to myelography.
- Findings suggest MR imaging should be a primary diagnostic modality for these conditions.