1. Diffusion tensor imaging of lumbar spinal nerves reveals changes in microstructural integrity following decompression surgery associated with improvements in clinical symptoms: A case report.
- Author
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Hughes SW, Hellyer PJ, Sharp DJ, Newbould RD, Patel MC, and Strutton PH
- Subjects
- Aged, Decompression, Surgical, Diffusion Tensor Imaging, Electromyography, Female, Humans, Radiculopathy complications, Radiculopathy diagnostic imaging, Radiculopathy surgery, Spinal Nerve Roots, Spinal Stenosis complications, Surveys and Questionnaires, Transcranial Magnetic Stimulation, Lumbar Vertebrae diagnostic imaging, Lumbar Vertebrae surgery, Spinal Nerves diagnostic imaging, Spinal Stenosis diagnostic imaging, Spinal Stenosis surgery
- Abstract
The outcomes from spinal nerve decompression surgery are highly variable with a sizable proportion of elderly foraminal stenosis patients not regaining good pain relief. A better understanding of nerve root compression before and following decompression surgery and whether these changes are mirrored by improvements in symptoms may help to improve clinical decision-making processes. This case study used a combination of diffusion tensor imaging (DTI), clinical questionnaires and motor neurophysiology assessments before and up to 3 months following spinal decompression surgery. In this case report, a 70-year-old women with compression of the left L5 spinal nerve root in the L5-S1 exit foramina was recruited to the study. At 3 months following surgery, DTI revealed marked improvements in left L5 microstructural integrity to a similar level to that seen in the intact right L5 nerve root. This was accompanied by a gradual improvement in pain-related symptoms, mood and disability score by 3 months. Using this novel multimodal approach, it may be possible to track concurrent improvements in pain-related symptoms, function and microstructural integrity of compressed nerves in elderly foraminal stenosis patients undergoing decompression surgery., Competing Interests: Declaration of competing interest None., (Copyright © 2020. Published by Elsevier Inc.)
- Published
- 2020
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