Specific foraminal changes originate from degenerative spondylolisthesis on computed tomographic images

Area of Science:

• Spinal Surgery
• Radiology
• Neurosurgery

Background:

• Operative treatment for degenerative spondylolisthesis (DS) is associated with a high incidence of nerve injury.
• Hypertrophied facet joints are significant factors impacting adjacent nerves within the foraminal structures.

Purpose of the Study:

• To identify specific foraminal changes associated with degenerative spondylolisthesis (DS).
• To determine the relationship between these foraminal changes and nerve injury during operative treatment.

Main Methods:

• CT images from 70 patients with DS and 50 controls were analyzed.
• Measurements of foraminal structure length and height were taken on sagittal reconstructions.
• Horizontal stenosis was evaluated, and statistical tests (Chi-square, T-test) were performed.

Main Results:

• Hyperplasia of the superior articular process (SAP) and articular capsule (Ac) was significantly more common in the DS group.
• SAP and Ac dimensions were significantly greater in the DS group compared to controls.
• SAP and Ac hyperplasia were frequently accompanied by horizontal stenosis of the intervertebral foramen in DS patients.

Conclusions:

• Degenerative spondylolisthesis (DS) is characterized by excessive SAP and Ac hyperplasia.
• These hyperplastic changes are potential causes of nerve root injury post-surgery.
• Focusing on SAP and Ac during surgery is essential to mitigate nerve injury risks.