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Research ArticleSpine Imaging and Spine Image-Guided Interventions

Lumbar Root Compression in the Lateral Recess: MR Imaging, Conventional Myelography, and CT Myelography Comparison with Surgical Confirmation

Walter S. Bartynski and Luke Lin
American Journal of Neuroradiology March 2003, 24 (3) 348-360;
Walter S. Bartynski
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Luke Lin
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Abstract

BACKGROUND AND PURPOSE: Previous authors have shown that conventional myelography is superior to plain CT in the assessment of root compression in the lateral recess, but this question has never been evaluated with respect to MR imaging of the lumbar level. Our purpose was to assess the accuracy of MR imaging, conventional myelography, and postmyelography CT (CT myelography) of the lumbar level in identifying degenerative lateral recess root compression with surgical confirmation.

METHODS: MR imaging, conventional myelography, and CT myelography of the lumbar level were assessed in the imaging of 58 lateral recesses at 38 lumbar levels in 26 patients who underwent surgery for radiculopathy with degenerative lateral recess abnormality. Each lateral recess was graded as normal, small without root compression, small with root compression, or severe root compression.

RESULTS: MR imaging underestimated root compression in 28% to 29% of the cases in which root impingement was surgically confirmed. Conventional myelography underestimated root compression in only 5% to 7% of the cases and correctly predicted impingement in 93% to 95%. CT myelography underestimated root compression in 38% of the surgically confirmed cases.

CONCLUSION: MR imaging significantly underestimated root compression caused by degenerative changes in the lateral recess. Although MR imaging is a superb study when used in the search for degenerative disk disease and disk protrusion, conventional myelography is a crucial supplemental study that is necessary to confirm degenerative root impingement in the lateral recess as the cause of radiculopathy.

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American Journal of Neuroradiology: 24 (3)
American Journal of Neuroradiology
Vol. 24, Issue 3
1 Mar 2003
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Cite this article
Walter S. Bartynski, Luke Lin
Lumbar Root Compression in the Lateral Recess: MR Imaging, Conventional Myelography, and CT Myelography Comparison with Surgical Confirmation
American Journal of Neuroradiology Mar 2003, 24 (3) 348-360;

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Lumbar Root Compression in the Lateral Recess: MR Imaging, Conventional Myelography, and CT Myelography Comparison with Surgical Confirmation
Walter S. Bartynski, Luke Lin
American Journal of Neuroradiology Mar 2003, 24 (3) 348-360;
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