Evaluation of foraminal cross-sectional area in lumbar spondylolisthesis using kinematic MRI.
PURPOSE
To evaluate the kinematic change of cross-sectional area of lumbar intervertebral foramen in degenerative lumbar spondylolisthesis patients using multi-positional MRI.


METHODS
Multi-positional MRI was performed on 31 patients diagnosed with single or multilevel degenerative lumbar spondylolisthesis and 31 control patients without degenerative lumbar spondylolisthesis. Foraminal area (FA) was measured at the lumbar spondylolisthesis level in degenerative lumbar spondylolisthesis group and at L3-4, L4-5, and L5-S1 level in the control group. FA was measured bilaterally in neutral, flexion, and extension positions. The difference in FA between the groups was analyzed using Mann-Whitney U test, and the difference between positions within groups was analyzed using Wilcoxon signed-rank test.


RESULTS
Degenerative lumbar spondylolisthesis group showed significantly smaller FA on both sides and on average in all three positions compared to the control group (p < 0.05 all). From neutral to flexion position, the change in FA was significantly smaller in the degenerative lumbar spondylolisthesis group than in the control group on both sides and on average (p < 0.005 all). In degenerative lumbar spondylolisthesis group, the FA showed no significant change from neutral to flexion, but showed significant change from neutral to extension (p < 0.005 all).


CONCLUSIONS
FA in the degenerative lumbar spondylolisthesis group was smaller than in the control group. There was no difference in FA in degenerative lumbar spondylolisthesis group from neutral to flexion, only from neutral to extension. Patients with degenerative lumbar spondylolisthesis have a higher chance of developing foraminal stenosis.
['Paholpak|Permsak|P|', 'Nazareth|Alexander|A|', 'Khan|Yusuf A|YA|', 'Khan|Sameer U|SU|', 'Ansari|Faisal|F|', 'Tamai|Koji|K|', 'Buser|Zorica|Z|http://orcid.org/0000-0002-5680-0643', 'Wang|Jeffrey C|JC|']
D000328:Adult D016022:Case-Control Studies D005260:Female D006801:Humans D008159:Lumbar Vertebrae D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D011187:Posture D013168:Spondylolisthesis
Lumbar spondylolisthesis Degenerative lumbar Multi-positional MRI Foraminal stenosis Degenerative spondylolisthesis Foramina area