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Myelography in lumbar spondylolisthesis
Acta Radiologica: Diagnosis
|January 1, 1978
Summary
Lumbar spondylolisthesis can cause radicular syndrome, often due to root pocket amputation, not typically disc herniation. Imaging findings for L5 spondylolisthesis differ from L4, influencing surgical decisions.
Area of Science:
- Neurosurgery
- Radiology
- Orthopedics
Background:
- Lumbar spondylolisthesis is a common spinal condition.
- Radicular syndrome presents with nerve root compression symptoms.
- Differentiating causes of radicular syndrome is crucial for effective treatment.
Purpose of the Study:
- To analyze radiographic and myelographic findings in patients with lumbar spondylolisthesis and radicular syndrome.
- To compare L4 and L5 spondylolisthesis characteristics.
- To identify the primary causes of radicular syndrome in this patient cohort.
Main Methods:
- Retrospective analysis of radiography and myelography.
- Inclusion of 41 patients diagnosed with lumbar spondylolisthesis and radicular syndrome.
- Evaluation of imaging features related to spondylolisthesis and nerve root compromise.
Main Results:
- L5 spondylolisthesis exhibited distinct features compared to L4 spondylolisthesis.
- Root pocket amputation was the most frequent cause of radicular syndrome, occasionally asymptomatic.
- Disc herniation was infrequent and challenging to diagnose.
- Complete or near-complete subarachnoid space block was rare but indicated surgery.
Conclusions:
- Root pocket amputation is a significant, sometimes occult, cause of radicular syndrome in lumbar spondylolisthesis.
- Diagnostic challenges exist for disc herniation and subarachnoid block in this context.
- Imaging findings, particularly subarachnoid block, strongly influence surgical intervention decisions.