Radiologia Brasileira. Print version ISSN equina: review of the literature. Raízes nervosas redundantes da cauda equina: revisão da literatura. Imagenologia en Equinos. Public. · Hosted by Can-Horse Asesoria Veterinaria y etológica. Interested. clock. Mar 18, at AM – Mar 19, at PM. Dec 3, at AM – Dec 4, at PM UTC More than a year ago. pin. CESPO. Avenida Boyacá No A – 55, Bogotá, Colombia. Show Map.
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Statistically significant difference in relation to clinical symptoms was found between groups A and C. They also have not found any significant difference in the electrophysiological manifestation between ventral and dorsal redundant nerve roots. Low degree of nerve cells loss and spinal ganglion fibrosis were observed, but such changes were equally present in non-redundant roots and were, therefore, considered as changes related to aging.
The redundant nerve root syndrome of the cauda equina.
The opening of the dura mater may be performed to rule out the hypothesis of arteriovenous malformation 7 or simply because surgeons have decided that such a procedure should be a part of the decompression 6, Redundant nerve roots of the cauda equina caused by lumbar spinal canal stenosis.
Other diseases can cause hypertrophic neuropathy such as arachnoiditis, chronic inflammatory demyelinat-ing polyneuropathy and some hereditary neuropathies; but association between such entities and serpiginous nerve roots of cauda equina was not reported.
Redundancy of the nerve roots is probably the pathological result of a chronic compressive force at the level of the site of spinal canal constriction 9. Also, there are reports on the indication of duroplasty in association with decompressive laminectomy was indicated for the relief of nerve root compression 11, J Bone Joint Surg Br. Redundant nerve roots in the cauda equina. At MRI, the main differential diagnosis must be done with dural arteriovenous malformations or arteriovenous fistulas.
Dural arteriovenous fistula is usually associated with abnormalities in signal intensity of the spinal cord on MRI T2-weighted sequences The relative length was obtained by measuring the distance from the maximum stenosis level to the most distant point where the presence of redundant roots could be identified, and by dividing such obtained value by the height of the vertebral body located above the stenosis level.
The literature is controversial on the clinical relevance of the presence of redundant roots of the cauda equina. Sagittal MRI T2-weighted image demonstrates degenerative changes of the spine with disc herniation and vertebral canal stenosis at L and L levels arrowhead.
At the images, arteriovenous malformations are frequently associated with great draining vessels, and may clinically present with signs of myelopathy, subarachnoid hemorrhage or medullary ischemia 7, Surgically confirmed spinal arteriovenous fistula. The present paper is aimed at reviewing the histopathological, electrophysiological and imaging findings, particularly at magnetic resonance imaging, as well as the clinical meaning of this entity.
The clinical condition of patients with RNR of the cauda equina is related to the natural history of the lumbar spinal canal stenosis. Statistically significant difference in relation to clinical symptoms was found between groups A and C. The study authors have suggested that such results reflected the reduction and degeneration of the nerve fibers 8.
The literature is controversial on the clinical relevance of the presence of redundant roots of the cauda equina. There are articles suggesting that the degenerative pathological changes in the affected nerve roots are irreversible and, therefore, the neurological symptoms would be less likely to improve with surgical decompression, but consensus is still to be reached on such concept.
In their investigation, those authors have not demonstrated any significant change in the anterior horn and in the anterolateral columns of the spinal cord. Thickened, elongated and tortuous or serpiginous nerve roots adjacent to a site of lumbar vertebral canal stenosis represent typical findings.
Radiologia Brasileira – Raízes nervosas redundantes da cauda equina: revisão da literatura
How to cite this article. In two other studies, the postoperative improvement was not statistically different in patients with and without RNR of the cauda equina 12,13but in one of those studies a tendency towards worse results for patients with RNR of the cauda equina was identified, similarly to the results reported by Ono et al.
Therefore the authors of the present review suggest that radiologists should look for RNR of the cauda equina at MRI and, if applicable, describe such finding in their reports. The prevalence of this syndrome may reach The present study authors did not find any other study investigating such type of imaging finding in relation to postsurgical outcomes.
Curso de Imagenología en Equinos Atletas
Dural arteriovenous fistula is usually associated with abnormalities in signal intensity of the spinal cord on MRI T2-weighted sequences Presence of increased signal intensity in the spinal cord substance arrowhead associated with medullary ischemia secondary to steal phenomenon. Spinal dural arteriovenous fistulas: Mobile neurinoma of the cauda equina.
This is not an independent entity, but it is believed to be a consequence of the chronic compression at the level of the lumbar canal stenosis and thus may be part of the lmagenologia history of lumbar spinal stenosis.
Redundant nerve roots in the cauda equina. In their investigation, those authors have not demonstrated any significant change in the anterior horn and in the anterolateral columns of the spinal cord. In that study, the velocity of conduction of redundant nerve roots was approximately one half the normal value and, in general, the redundant nerve roots presented multiphase action potentials temporarily dispersed as compared with the normal roots.
Imagenologia en Equinos
Therefore the authors of the present review suggest that radiologists should look for RNR of the cauda equina at MRI and, if applicable, describe such finding in their reports. Cauda equina; Spinal stenosis; Spine; Magnetic resonance imaging. Axial MRI T2-weighted image obtained at a level slightly above the L stenosis, also presenting tortuous nerve roots arrow.
At MRI, RNR are often associated with degenerative stenosis of the lumbar vertebral canal and therefore the recognition of such entity is important to avoid equivocal diagnosis and mainly false-positive results for eqyina malformations.