Impact of MR Neurography in Patients with Chronic Cauda Equina Syndrome Presenting as Chronic Pelvic Pain and Dysfunction
Autor: | Avneesh Chhabra, Jason Petrasic, Kelly M. Scott |
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Rok vydání: | 2016 |
Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Tarlov cyst Lumbosacral Plexus Neuroimaging Physical examination Cauda equina syndrome Pelvic Pain 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine Prevalence medicine Humans Radiology Nuclear Medicine and imaging Neural Tube Defects Polyradiculopathy Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Magnetic resonance neurography Pelvic pain Cauda equina Middle Aged medicine.disease Magnetic Resonance Imaging Tarlov Cysts Spine Surgery Lumbosacral plexus medicine.anatomical_structure Female Neurology (clinical) Chronic Pain Arachnoiditis medicine.symptom business 030217 neurology & neurosurgery |
Zdroj: | AJNR Am J Neuroradiol |
ISSN: | 1936-959X 0195-6108 |
Popis: | BACKGROUND AND PURPOSE: Chronic cauda equina syndrome, defined as persistent damage of the cauda equina nerve roots within the spinal canal can be a challenging diagnosis with varied presentations. MR neurography imaging is more commonly being used to evaluate the lumbosacral spine of patients suspected of having subacute or chronic cauda equina syndrome. Our aim was to evaluate the impact of lumbosacral plexus MR neurography in the diagnostic thinking and therapeutic management of patients presenting with chronic pelvic pain and dysfunction and suspected chronic cauda equina syndrome. MATERIALS AND METHODS: Consecutive MR neurography lumbosacral plexus examinations at our institution were reviewed retrospectively. Relevant data collected included the following: patient demographics, clinical history, pertinent physical examination findings, preimaging diagnostic impression, prior MR imaging lumbar spine findings, MR neurography findings, postimaging diagnosis, and postimaging treatment plan. The impact of imaging on the preimaging clinical diagnosis and therapeutic management was evaluated. RESULTS: Of 185 studies of patients who presented with chronic pelvic pain and/or dysfunction, 23 with clinically suspected chronic cauda equina syndrome and imaging findings were included in the study (2 subjects were lost to follow-up). The mean ages were 53 ± 12 years and 53 ± 16 years for men and women, respectively. The common etiologies included arachnoiditis (n = 8), tethered cord (n = 2), and simple/Tarlov cysts (n = 3). Eighteen of 23 (78%) subjects had a change in diagnosis resulting from MR neurography findings, and 5/23 (22%) had no change. Seventeen of 21 (81%) subjects had a change in management, and 4/21 (19%) had no change. CONCLUSIONS: MR neurography impacts the diagnosis and therapeutic management of patients with suspected chronic cauda equina syndrome. |
Databáze: | OpenAIRE |
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