In Vivo Detection of the Lumbar Intraforaminal Ligaments by MRI

Overview

Journal Eur Spine J

Specialty Orthopedics

Date 2022 Mar 11

PMID 35275254

Authors

Jeanette Henkelmann

Dina Wiersbicki

Hanno Steinke

Timm Denecke

Christoph-Eckhard Heyde

Anna Voelker

Affiliations

Soon will be listed here.

Abstract

Purpose: Intraforaminal ligaments (IFL) are of great interest to anatomists and clinicians to fully understand the detailed anatomy of the neuroforamina and to diagnose unclear radicular symptoms. Studies published until now have described radiological imaging of the IFLs using magnetic resonance imaging (MRI) on donor bodies. In the present study, we investigated the detectability of lumbar IFLs in vivo in adults using the high spatial resolution of the constructive interference in steady state (CISS) sequence.

Methods: A total of 14 patients were studied using a 1.5 T MRI scanner. The lumbar spine was imaged using the parasagittal CISS sequence, and the detectability of the IFLs was assessed for each lumbar level. All image datasets were analyzed by a radiologist, an orthopedic surgeon, and an anatomist. Interrater reliability was expressed as Fleiss' Kappa. Using a single data set, a three-dimensional (3D) model was created to map the location of the IFLs within the intervertebral foramen (IF) and the immediate surrounding vessels.

Results: Overall, the radiologist was able to detect IFLs in 60% of all imaged IFs, the orthopedic surgeon in 62%, and the anatomist in 66%. Fleiss' Kappa for the various segments varies from 0.71 for L4/5 up to 0.90 for L3/4.

Conclusion: Lumbar IFLs were successfully detected in vivo in every patient. The detection frequency varied from 42-86% per IF. We demonstrated reproducible imaging of the IFLs on MRI, with good interrater reliability. The present study was a launching point for further clinical studies investigating the potential impact of altered IFLs on radicular pain.

Citing Articles

Intervertebral Canals and Intracanal Ligaments as New Terms in .

Zhandarov K, Blinova E, Ogarev E, Sheptulin D, Terekhina E, Telpukhov V Diagnostics (Basel). 2023; 13(17).

PMID: 37685348 PMC: 10486485. DOI: 10.3390/diagnostics13172809.

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