Normative Measurements of L1-S1 Neuroforaminal Dimensions derived from Plain Film Radiography, Computed Tomography, and Magnetic Resonance Imaging.

STUDY DESIGN

retrospective cohort.

OBJECTIVE

To report normative measurements of L1-S1 lumbar neuroforamina on plain film radiography (PFR), computed tomography (CT), and magnetic resonance imaging (MRI), accounting for patient sex and ethnicity.

SUMMARY OF BACKGROUND DATA

Quantitative criteria for diagnosis of neuroforaminal stenosis (NFS) remains unknown. Acquiring a thorough understanding of normative foraminal dimensions is a key step in formulating objective parameters for NFS.

METHODS

We measured 988 images from 494 patients between 18 and 35 years-old without spinal pathology who received PFR, CT, or MRI within one year of each other. Neuroforaminal measurements were defined as the height, area, and sagittal and axial widths. Statistical analyses were performed to assess relationships among PFR-, CT-, and MRI-derived neuroforaminal measurements as well as the influence of patient sex and ethnicity.

RESULTS

330 PFR, 377 CT, and 281 MRI were measured. Of these, 213 PFR and CT, 117 PFR and MRI, and 164 MRI and CT intrapatient images were compared. Statistically significant differences were observed among PFR, CT, and MRI measurements across all levels L1-S1. PFR measurements were larger compared to those derived from CT and MRI. Weak-to-moderate correlations were observed between PFR and CT, PFR and MRI, and CT and MRI, with the magnitude of correlation decreasing caudally from L1-S1. Variations in neuroforaminal anatomy were observed based on sex and ethnicity.

CONCLUSION

This study reports 25,951 measurements of normal L1-S1 neuroforaminal anatomy assessed by PFR, CT, and MRI. The values reported in this study may be used as normative reference measurements of the lumbar neuroforamina. PFR measurements of the neuroforamina are larger compared to those derived from CT and MRI across all levels from L1-S1. There is poor correlation among PFR, CT and MRI when measuring the lumbar neuroforamina. Differences in neuroforaminal anatomy are evident based on patient sex and ethnicity.

Informations de copyright

Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Déclaration de conflit d'intérêts

Conflicts of Interest and Source of Funding: Dr. Wayne Cheng reports consulting for Medtronic and Orthofix, a research grant from DePuy Synthes, and speaking and consultation for Radius. Dr. Olumide Danisa declares royalties from Globus Medical, consultation for Stryker, reimbursement for travel and expenses for services as an oral examiner for the American Board of Orthopaedic Surgery (ABOS), and reimbursement for travel to the annual meeting of the Musculoskeletal Transplant Foundation as a medical board member. Uncompensated disclosures for Dr. Danisa include his service on the patient safety committee for the North American Spine Society, the spine education committee for Orthopaedic Research Society and American Academy of Orthopaedic Surgeons (AAOS), and associate editor for SpineLine and NASSJ. For all remaining authors no conflicts of interest are declared. The author(s) received no financial or material support for the research, authorship, and/or publication of this article. The authors report no conflicts of interest specific to the research, authorship, and/or publication of this article.