Assessment of lumbar spinal canal stenosis by magnetic resonance phlebography |
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Authors: | Masakazu Manaka Masashi Komagata Kenji Endo Atsuhiro Imakiire |
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Institution: | (1) Department of Orthopaedic Surgery, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan, JP |
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Abstract: | There is evidence to suggest that cauda equina intermittent claudication is caused by local circulatory disturbances in the
cauda equina as well as compression of the cauda equina. We evaluated the role of magnetic resonance phlebography (MRP) in
identifying circulatory disturbances of the vertebral venous system in patients with lumbar spinal canal stenosis. Extensive
filling defects of the anterior internal vertebral venous plexus were evident in patients with lumbar spinal canal stenosis
(n = 53), whereas only milder abnormalities were noted in patients with other lumbar diseases (n = 16) and none in normal subjects (n = 13). The extent of the defect on MRP correlated with the time at which intermittent claudication appeared. In patients
with lumbar spinal canal stenosis, extensive defects of the internal vertebral venous plexus on MRP were noted in the neutral
spine position, but the defect diminished with anterior flexion of the spine. This phenomenon correlated closely with the
time at which intermittent claudication appeared. Our results highlight the importance of MRP for assessing the underlying
mechanism of cauda equina intermittent claudication in patients with lumbar spinal canal stenosis and suggest that congestive
venous ischemia is involved in the development of intermittent claudication in these patients.
Received: January 16, 2002 / Accepted: August 5, 2002
Offprint requests to: M. Manaka |
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Keywords: | MRI Phlebography Lumbar spinal canal stenosis |
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