腰椎椎間孔部神経根障害の臨床像および画像の特徴

Clinical and Imaging Characteristics of Foraminal Nerve Root Disorders of the Lumbar Spine

　腰椎椎間孔部神経根障害の特徴を調査するために，椎間孔狭窄症(FS)19例，椎間孔ヘルニア(FH)38例を腰部脊柱管狭窄症(LCS)21例と比較し，JOAスコア，X線写真の椎間板変性度，椎間孔部の形態計測，MRI画像の椎間孔部所見を検討した．FS群で下肢痛，歩行能力，FHで腰痛，下肢痛，知覚障害が強かった．FS，FHともに椎間孔前後径が短い．FSは椎間板変性度が強く，椎間孔上部長が短かった．MRI像椎間孔部black outの陽性率はFS63.6％，FH75％であった．

　We analyzed cases of lumbar nerve root compression at intervertebral foramina, by comparing 19 cases of foraminal stenosis (FS), and 38 cases of foraminal hernia (FH) with 21 cases of lumbar canal stenosis (LCS).　JOA scores, intervertebral disc degeneration, anatomical measurements of the nerve root foramina and the MRI findings were reviewed.　The scores for pain in the lower extremities, and walking ability were both lowest in the FS group.　The scores for low back pain, lower extremities, and sensory disturbances were lowest in the FH group.　Anterior-posterior diameters of the nerve root foramina were smaller in the FS group and FH group than in the LCS group.　More degenerated discs and short length of upper part of the nerve root foramina were seen in FS group than in the other groups.　The MRI images of so-called black out nerve root foramina were positive in 63.6% of FS cases, 75% of FH cases.