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European Spine Journal

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01-04-2019 | Leg Pain | Original Article

Identification of abnormalities in the lumbar nerve tract using diffusion-weighted magnetic resonance neurography

Authors: Hiroaki Manabe, Toshinori Sakai, Ryo Miyagi, Fumitake Tezuka, Kazuta Yamashita, Yoichiro Takata, Koichi Sairyo

Published in: European Spine Journal | Issue 4/2019

Abstract

Introduction

Abnormalities of the lumbar nerve tract caused by congenital variations or high nerve root take-off angles are difficult to visualize. Diffusion-weighted magnetic resonance neurography (DW-MRN) has recently been introduced for imaging of the lumbosacral region. The aims of this study were to identify lumbar nerve tract abnormalities caused by congenital variation or a high nerve root take-off angle using DW-MRN and to assess the diagnostic value of this imaging modality.

Methods

A total of 573 magnetic resonance images from 575 patients (261 men, 314 women; mean age 58.5 years) with low back/leg pain were retrospectively analyzed. We classified congenital variations in the lumbar nerve roots using the Neidre and MacNab criteria and investigated nerve roots with a take-off angle of 60° or more.

Results and discussion

Congenital variations were identified in 8 patients (9 nerve roots, 1.6%). The most commonly identified variation was in the sacral nerve root (n = 5) followed by the L4 (n = 3) and L5 (n = 1) nerve roots. All variations identified were on the left side. There were 3 cases of type 1a variation, 1 of type 1b, 1 of type 2, and 4 of type 3. In total, 210 (36.6%) of the magnetic resonance images showed high nerve root take-off angles at the intervertebral foramen that was caused by disk herniation, spondylolisthesis, or osteophytes with degeneration. Patients with high nerve root take-off angles were significantly older than those without (P < 0.05).

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.

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Title: Identification of abnormalities in the lumbar nerve tract using diffusion-weighted magnetic resonance neurography
Authors: Hiroaki Manabe
Toshinori Sakai
Ryo Miyagi
Fumitake Tezuka
Kazuta Yamashita
Yoichiro Takata
Koichi Sairyo
Publication date: 01-04-2019
Publisher: Springer Berlin Heidelberg
Keywords: Leg Pain
Leg Pain
Published in: European Spine Journal / Issue 4/2019
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-018-05867-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Identification of abnormalities in the lumbar nerve tract using diffusion-weighted magnetic resonance neurography

Abstract

Introduction

Methods

Results and discussion

Graphical abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results and discussion

Graphical abstract

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