Faculty Collaboration Database

Quantitative correlation of lumbar foraminal stenosis with local morphological metrics. Eur Spine J 2021 Nov;30(11):3319-3323

Date

07/29/2021

Pubmed ID

34318337

DOI

10.1007/s00586-021-06944-8

Scopus ID

2-s2.0-85111401747 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

PURPOSE: Clinical evaluation of lumbar foraminal stenosis typically includes qualitative assessments of perineural epidural fat content around the spinal nerve root and evaluation of nerve root impingement. The present study investigates the use of several morphological MRI-derived metrics as quantitative predictors of foraminal stenosis grade.

METHODS: 62 adult patients that underwent lumbar spine MRI evaluation over a 1-month duration in 2018 were included in the analysis. Radiological gradings of stenosis were captured from the existing clinical electronic medical record. Clinical gradings were recorded using a 0-5 scale: 0 = no stenosis, 1 = mild stenosis, 2 = mild-moderate stenosis, 3 = moderate stenosis, 4 = moderate-severe stenosis, 5 = severe stenosis. Quantitative measures of perineural epidural fat volume, nerve root cross-sectional area, and lumbar pedicle length were derived from T1 weighted sagittal spine MRI on each side of all lumbar levels. Spearman correlations of each measured metric at each level were then computed against the stenosis gradings.

RESULTS: A total of 347 volumetric segmentation and radiological foraminal stenosis grade sets were derived from the 62-subject study cohort. Statistical analysis revealed significant correlations (p < 0.001) between the volume of perineural fat and stenosis grades for all lumbar vertebral levels.

CONCLUSION: The results of the study have demonstrated that segmented volumes of perineural fat predict the severity of clinically scored foraminal stenosis. This finding motivates further development of automated perineural fat segmentation methods, which could offer a quantitative imaging biometric that yields more reproducible diagnosis, assessment, and tracking of foraminal stenosis.

Author List

Gunasekaran VS, Hejdak D, Meyer B, Klein A, Koch K

Author

Andrew P. Klein MD Chief, Associate Professor in the Radiology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Benchmarking
Constriction, Pathologic
Humans
Lumbar Vertebrae
Lumbosacral Region
Magnetic Resonance Imaging
Spinal Stenosis