Gravity determines the direction of nerve roots sedimentation in the lumbar spinal canal

BMC Musculoskeletal Disorders

Xin Yao¹  Jun Yang¹  Nian Chen¹  Yongyu Zheng¹  Tingjie Zhou¹  Jiang Yang¹  Taifeng Xu¹  Zhenhua Hong²  Zhiyun Feng³  Linting Zhang⁴ 

[1] Department of Orthopedic Surgery, Sanmen People’s Hospital, Taizhou, China;Department of Orthopedic Surgery, Taizhou Hospital, Taizhou, China;Department of Orthopedic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China;Operating room, Sanmen People’s Hospital, Taizhou, China;

关键词: Lumbar spinal stenosis;    Gravity;    Prone position magnetic resonance imaging;    Nerve roots sedimentation sign;   

DOI  :  10.1186/s12891-021-04032-y

来源: Springer

【 摘 要 】

ObjectivesTo investigate the role of gravity in the sedimentation of lumbar spine nerve roots using magnetic resonance (MR) imaging of various body positions.MethodsA total of 56 patients, who suffered from back pain and underwent conventional supine lumbar spine MR imaging, were selected from sanmen hospital database. All the patients were called back to our hospital to perform MR imaging in prone position or lateral position. Furthermore, the sedimentation sign (SedSign) was determined based on the suspension of the nerve roots in the dural sac on cross-sectional MR images, and 31 cases were rated as positive and another 25 cases were negative.ResultsThe mean age of negative SedSign group was significantly younger than that of positive SedSign group (51.7 ± 8.7 vs 68.4 ± 10.5, P < 0.05). The constitutions of clinical diagnosis were significantly different between patients with a positive SedSign and those with a negative SedSign (P < 0.001). Overall, nerve roots of the vast majority of patients (48/56, 85.7%) subsided to the ventral side of the dural sac on the prone MR images, although that of 8 (14.3%) patients remain stay in the dorsal side of dural sac. Nerve roots of only one patient with negative SedSign did not settle to the ventral dural sac, while this phenomenon occurred in 7 patients in positive SedSign group (4% vs 22.6%, P < 0.001). In addition, the nerve roots of all the five patients subsided to the left side of dural sac on lateral position MR images.ConclusionsThe nerve roots sedimentation followed the direction of gravity. Positive SedSign may be a MR sign of lumbar pathology involved the spinal canal.

【 授权许可】

CC BY