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Radiological Significance of Ligamentum Flavum Hypertrophy in the Occurrence of Redundant Nerve Roots of Central Lumbar Spinal Stenosis

Hur, Junseok W. and Hur, Junho K. and Kwon, Taek-Hyun and Park, Young-Khan and Chung, Hung Seob and Kim, Joo Han (2012) Radiological Significance of Ligamentum Flavum Hypertrophy in the Occurrence of Redundant Nerve Roots of Central Lumbar Spinal Stenosis. Journal of Korean Neurosurgical Society, 52 (3). pp. 215-220. ISSN 2005-3711.

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Objective: There were previous reports of redundant nerve roots (RNRs) focused on their clinical significance and pathogenesis. In this study, we investigated the significant radiologic findings that correlate with RNRs occurrence. These relations would provide an advanced clue for clinical significance and pathogenesis of RNRs. Methods: Retrospective research was performed with data from 126 patients who underwent surgery for central lumbar spinal stenosis (LSS). Finally, 106 patients with common denominators (inter-observer accuracy : 84%) were included on this study. We divided the patients into two groups by MRI, patients with RNRs and those with no RNRs (NRNRs). Comparative analyses were performed with clinical and radiologic parameters. Results: RNRs were found in 45 patients (42%) with central LSS. There were no statistically significant differences between the two groups in severity of symptoms. On the other hand, we found statistically significant differences in duration of symptom and number of level included (p<0.05). In the maximal stenotic level, ligamentum flavum (LF) thickness, LF cross-sectional area (CSA), dural sac CSA, and segmental angulation are significantly different in RNRs group compared to NRNRs group (p<0.05). Conclusion: RNRs patients showed clinically longer duration of symptoms and multiple levels included. We also confirmed that wide segmental angulation and LF hypertrophy play a major role of the development of RNRs in central LSS. Together, our results suggest that wide motion in long period contribute to LF hypertrophy, and it might be the key factor of RNRs formation in central LSS.

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Additional Information:© 2012 The Korean Neurosurgical Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Received : March 14, 2012. Revised: June 23, 2012. Accepted: September 17, 2012. Published online 2012 September 30. This research was supported by the Basic Science Research Program of the National Research Foundation of Korea (NRF), funded by the Ministry of Education, Science and Technology (2011-0021292).
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National Research Foundation of KoreaUNSPECIFIED
Ministry of Education, Science and Technology (Korea)2011-0021292
Subject Keywords:Redundant nerve roots; Central lumbar spinal stenosis; Ligamentum flavum hypertrophy.
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Official Citation:Radiological Significance of Ligamentum Flavum Hypertrophy in the Occurrence of Redundant Nerve Roots of Central Lumbar Spinal Stenosis Junseok W Hur, Junho K Hur, Taek-Hyun Kwon, Youn Kwan Park, Hung Seob Chung, Joo Han Kim J Korean Neurosurg Soc. 2012 September; 52(3): 215–220. Published online 2012 September 30. doi: 10.3340/jkns.2012.52.3.215 PMCID: PMC3483322
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:35686
Deposited By: Ruth Sustaita
Deposited On:27 Nov 2012 23:23
Last Modified:03 Oct 2019 04:30

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