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Efficacy of computed tomography in prediction of operability of L5/S1 foraminal stenosis using region of interest: A STROBE-compliant retrospective study

Symptoms of intervertebral foraminal stenosis are caused by compression of nerve root exiting the intervertebral foramen. Many attempts to measure the size of the neuromuscular exit have been made; however, only a few studies to compare the area differences between foramens by computed tomography (C...

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Autores principales: Shim, Dong Woo, Lee, Byung Ho, Seo, Jiwoon, Hong, Hyunjoo, Shin, Sung Chul, Kim, Hak Sun
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824739/
https://www.ncbi.nlm.nih.gov/pubmed/31626098
http://dx.doi.org/10.1097/MD.0000000000017422
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author Shim, Dong Woo
Lee, Byung Ho
Seo, Jiwoon
Hong, Hyunjoo
Shin, Sung Chul
Kim, Hak Sun
author_facet Shim, Dong Woo
Lee, Byung Ho
Seo, Jiwoon
Hong, Hyunjoo
Shin, Sung Chul
Kim, Hak Sun
author_sort Shim, Dong Woo
collection PubMed
description Symptoms of intervertebral foraminal stenosis are caused by compression of nerve root exiting the intervertebral foramen. Many attempts to measure the size of the neuromuscular exit have been made; however, only a few studies to compare the area differences between foramens by computed tomography (CT) were done. In this retrospective comparative study, we used the region of interest (ROI) in CT to measure and compare the area of intervertebral foramen between the healthy control group and the patient group. Eighty-one patients who underwent CT of the lumbar spine between May 2014 and December 2017 were enrolled. Using the medical imaging program, the foraminal area between L5 and S1 vertebrae was measured on the sagittal, coronal, and axial planes using ROI. Four groups were established for comparison: those diagnosed with foraminal stenosis by a radiologist and those who were not, those diagnosed with foraminal stenosis by orthopedic surgeons and those who were not. These groups were further divided into subcategories depending on whether the area was operated on for foraminal stenosis. Interobserver and intraobserver agreements were assessed. The mean age of patients was 56.5 years (range 17–84). The foraminal area of the surgical group on sagittal plane was significantly narrower than the control group (P = .005). However, the difference between the 2 groups on axial and coronal planes was not statistically significant (P > .1). Foraminal area <80 mm(2) on sagittal images was a statistically significant risk factor for clinical symptom (P = .028) and that <65 mm(2) was a statistically significant risk factor in predicting operability (P = .01). Interobserver and intraobserver agreements were fair to good on axial and coronal planes (about 0.7), whereas the agreements were excellent on sagittal plane (>0.9). In this study, we proved that measuring the intervertebral foraminal area using the ROI in CT in the lumbar spine is useful for diagnosing L5-S1 foraminal stenosis, especially on sagittal plane. Furthermore, not only does it provide aid in diagnosis, but it also helps predicting the operability of foraminal stenosis.
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spelling pubmed-68247392019-11-19 Efficacy of computed tomography in prediction of operability of L5/S1 foraminal stenosis using region of interest: A STROBE-compliant retrospective study Shim, Dong Woo Lee, Byung Ho Seo, Jiwoon Hong, Hyunjoo Shin, Sung Chul Kim, Hak Sun Medicine (Baltimore) 7100 Symptoms of intervertebral foraminal stenosis are caused by compression of nerve root exiting the intervertebral foramen. Many attempts to measure the size of the neuromuscular exit have been made; however, only a few studies to compare the area differences between foramens by computed tomography (CT) were done. In this retrospective comparative study, we used the region of interest (ROI) in CT to measure and compare the area of intervertebral foramen between the healthy control group and the patient group. Eighty-one patients who underwent CT of the lumbar spine between May 2014 and December 2017 were enrolled. Using the medical imaging program, the foraminal area between L5 and S1 vertebrae was measured on the sagittal, coronal, and axial planes using ROI. Four groups were established for comparison: those diagnosed with foraminal stenosis by a radiologist and those who were not, those diagnosed with foraminal stenosis by orthopedic surgeons and those who were not. These groups were further divided into subcategories depending on whether the area was operated on for foraminal stenosis. Interobserver and intraobserver agreements were assessed. The mean age of patients was 56.5 years (range 17–84). The foraminal area of the surgical group on sagittal plane was significantly narrower than the control group (P = .005). However, the difference between the 2 groups on axial and coronal planes was not statistically significant (P > .1). Foraminal area <80 mm(2) on sagittal images was a statistically significant risk factor for clinical symptom (P = .028) and that <65 mm(2) was a statistically significant risk factor in predicting operability (P = .01). Interobserver and intraobserver agreements were fair to good on axial and coronal planes (about 0.7), whereas the agreements were excellent on sagittal plane (>0.9). In this study, we proved that measuring the intervertebral foraminal area using the ROI in CT in the lumbar spine is useful for diagnosing L5-S1 foraminal stenosis, especially on sagittal plane. Furthermore, not only does it provide aid in diagnosis, but it also helps predicting the operability of foraminal stenosis. Wolters Kluwer Health 2019-10-18 /pmc/articles/PMC6824739/ /pubmed/31626098 http://dx.doi.org/10.1097/MD.0000000000017422 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle 7100
Shim, Dong Woo
Lee, Byung Ho
Seo, Jiwoon
Hong, Hyunjoo
Shin, Sung Chul
Kim, Hak Sun
Efficacy of computed tomography in prediction of operability of L5/S1 foraminal stenosis using region of interest: A STROBE-compliant retrospective study
title Efficacy of computed tomography in prediction of operability of L5/S1 foraminal stenosis using region of interest: A STROBE-compliant retrospective study
title_full Efficacy of computed tomography in prediction of operability of L5/S1 foraminal stenosis using region of interest: A STROBE-compliant retrospective study
title_fullStr Efficacy of computed tomography in prediction of operability of L5/S1 foraminal stenosis using region of interest: A STROBE-compliant retrospective study
title_full_unstemmed Efficacy of computed tomography in prediction of operability of L5/S1 foraminal stenosis using region of interest: A STROBE-compliant retrospective study
title_short Efficacy of computed tomography in prediction of operability of L5/S1 foraminal stenosis using region of interest: A STROBE-compliant retrospective study
title_sort efficacy of computed tomography in prediction of operability of l5/s1 foraminal stenosis using region of interest: a strobe-compliant retrospective study
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6824739/
https://www.ncbi.nlm.nih.gov/pubmed/31626098
http://dx.doi.org/10.1097/MD.0000000000017422
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