Imaging Study Of Cauda Equina Nerve And Its Clinical Significance

Objective: The anatomical structure and imaging characteristics of lumbosacral and cauda equina nerves,local morphology and course distribution were studied by using MRI imaging technology,providing imaging basis for surgical treatment of cauda equina syndrome(CES)and other local surgical diseases.Methods: From August 2017 to August 2018,60 patients suspected of cauda equina nerve injury syndrome were examined by lumbar magnetic resonance imaging in The First Affitiated Hospital of Hebei North University.Among them,26 were male and 34 were female.The age distribution ranged from 23 to 50 years old,with an average age of 35.8+11.2 years.There were no abnormal changes in the appearance of the spine,no displacement and fracture of the vertebral body in all subjects.There are definite neurological disorders.DiscoveryTM MR750 series 3.0TMRI produced by GE company was used in this study to examine the lumbosacral imaging of 60 patients.The images generated after the MRI scanning were transmitted to AW Volume Share 4 AW4.5 workstation.The results were processed by the image processing system and read by the imaging professionals.Based on the comprehensive analysis of the lumbosacral MRI images of 60 subjects,the relevant parameters of the lumbosacral cauda equina nerve were measured by three-dimensional reconstruction technology.SPSS20.0 statistical software was used for statistical analysis of data.In order to reduce the occurrence of errors and improve the accuracy of the study,the data collected from each part of each subject were measured three times,and finally the average value was calculated.Statistical methods of t test and analysis of variance were used to set P < 0.05 with statistical significance.Results:1.The diameter of the posterior roots of L2 to S1 spinal nerves was significantly larger than that of the anterior roots of the spinal nerves(P < 0.05).2.Of the 60 subjects,58 belonged to the latter type,accounting for 96.67% of the total subjects.The distance between L2,L3,L5 and S1 anterior lumbosacral nerve roots and the junction of the posterior roots and the dura mater from the left side was greater than that from the right side,and the difference between L3 and L5 was statistically significant(P<0.05).At position L4,the distance between the junction of anterior and posterior lumbosacral nerve roots and the dura mater was greater at the right side than at the left side,and the difference was statistically significant(P<0.05).3.The distance between L1 and L5 segments of spinal nerve roots to dura mater was significantly greater than that between anterior and posterior roots,and the difference was statistically significant(P<0.05).There was no significant difference in the distance between L1-S2 spinal nerve root and dura mater between anterior and posterior roots(P>0.05).4.The inferior pole of conus medullaris was located at the lower edge of L1 in 76.67% of the subjects,which was significantly different from other parts(P<0.05).5.The angle of L2-S2 segments followed up into the spinal cord,whether the maximum angle,the minimum angle or the average angle,had statistical significance(P<0.05).6.The differences in the distance between the lower margin of Tll and T12 vertebral bodies and the intersection points of nerve roots from L1 to S2 were statistically significant(P<0.05).Conclusion:1.NMR can accurately measure and locate the spinal nerve root,and it is an important method to study the spinal nerve and cauda equina nerve region in vivo.2.3D CISS technology can not only clearly display the movement of spinal nerve and cauda equina nerve,but also show the three-dimensional anatomy of its anterior and posterior roots,making its anatomical structure more intuitive,providing important imaging reference for clinicians to carry out relevant surgical operations.