The radio anatomical arrangement of nerve roots at L3 level in cauda equina sac is it affected by diseases?

Medicine (Baltimore). 2024 Jun 28;103(26):e38681. doi: 10.1097/MD.0000000000038681.

Abstract

An observational study to discover the common conditions affecting the lumbosacral region that may affect lumbosacral position and tension. All the patients, underwent MRI exaamination (magnetic resonance imaging) in the supine position, were examined by the same consultant radiologist. The article was revised by the institutional ethical approval committee. The position of the nerve roots was observed, and the number of nerve roots was calculated anterior to a line passing between the mid-transvers process of L3(third lumbar vertebra). The number of nerve roots ahead of this line was calculated by the radiologist at the level of the right intervertebral foramen and at the left one. This procedure was applied to the normal group, and 5 common pathological diseases were repeated including single-level lumbar disc prolapse, multiple-disc prolapse, multiple bulge, spinal stenosis and spondylolisthesis (at the level of L45 (fourth to fifth lumbar vertebrae) or L5S1 (fifth lumbar to first sacral vertebrae) being outside the study area, i.e., L3). We noticed significant difference in the number of the nerve roots between the cases with herniated discs, spinal stenosis, and spondylolisthesis with the normal group and the significance was in ascending increment in significance being the highest in cases with spondylolisthesis, and even in the groups of other pathologies which are statistically not significant, we noticed that the significance is proportional to the severity of the disease being the least in single level cases (p 0.427), to be more significant on cases with multiple prolapses(p 0.319) to be more in cases with multiple bulges to start to be statistically significant in herniated, higher significance in cases with spinal stenosis to be the highest in cases with spondylolisthesis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Cauda Equina* / anatomy & histology
  • Cauda Equina* / diagnostic imaging
  • Cauda Equina* / pathology
  • Female
  • Humans
  • Intervertebral Disc Displacement* / diagnostic imaging
  • Lumbar Vertebrae* / diagnostic imaging
  • Magnetic Resonance Imaging* / methods
  • Male
  • Middle Aged
  • Spinal Nerve Roots* / anatomy & histology
  • Spinal Nerve Roots* / diagnostic imaging
  • Spinal Nerve Roots* / pathology
  • Spinal Stenosis / diagnostic imaging
  • Spinal Stenosis / pathology
  • Spondylolisthesis* / diagnostic imaging
  • Spondylolisthesis* / pathology