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Visualisation of symptomatic nerve roots. Prospective study of contrast-enhanced MRI in patients with lumbar disc

T Toyone1, K Takahashi, H Kitahara

  • 1Department of Orthopaedic Surgery, School of Medicine, Chiba University, Japan.

The Journal of Bone and Joint Surgery. British Volume
|July 1, 1993
PubMed

Insights

Gadolinium-enhanced MRI effectively detects nerve root changes in sciatica patients. Enhancement grade correlates with sciatica severity, indicating blood-nerve barrier disruption and edema.

Area of Science:

  • Radiology
  • Neurology
  • Orthopedics

Background:

  • Sciatica is a common condition often caused by lumbar disc herniation.
  • Accurate detection of pathological nerve root changes is crucial for effective treatment.

Purpose of the Study:

  • To evaluate the utility of gadolinium diethylenetriaminepentaacetic acid-enhanced MRI in detecting nerve root pathology in patients with lumbar disc herniation-induced sciatica.
  • To correlate MRI enhancement patterns with the clinical severity of sciatica.

Main Methods:

  • Gadolinium-enhanced MRI was performed on 25 patients with unilateral sciatica due to lumbar disc herniation.
  • Nerve root enhancement within the root sleeve was graded: grade 0 (none), grade 1 (focal), and grade 2 (diffuse/homogeneous).

Main Results:

  • Enhancement was observed in affected nerve roots at the caudal edge of herniations.
  • A significant correlation was found between the grade of nerve root enhancement and the severity of sciatica symptoms.

Conclusions:

  • Gadolinium-enhanced MRI is a valuable tool for identifying pathological nerve root changes in sciatica.
  • Observed enhancement is likely due to blood-nerve barrier disruption and subsequent edema, correlating with clinical presentation.

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