Correlation between slippage between two adjacent vertebrae on lateral flexion x-ray and the obliquity of the exiting nerve root as measured on on the MRI of lumbo-sacral spine.
- Conditions
- Lumbosacral root disorders, not elsewhere classified,
- Registration Number
- CTRI/2021/03/032218
- Lead Sponsor
- Balwant Institute of Neurosciences and Intensive Trauma care
- Brief Summary
MRI has become an investigation of choice for patients of low back pain with radiculopathy. MRI doesn’t consistently detect spondylolisthesis. In far lateral sagittal T2 MRI images, exiting nerve roots are seen descending vertically. We observed that the obliquity of these descending nerve roots may be related to spondylolisthesis
We plan to study prospectively study about 200 patients who have attended our OPD department for consultation for lumbosacral radiculopathy in the next two years.
We will do a thorough clinical examination after noting down the history. We will study their MRI lumbosacral spine and lateral flexion-extension X-rays for the presence or absence of listhesis.
We will consider spondylolisthesis to be present when vertebral slip is seen greater than three millimeters on lateral standing flexion-extension radiographs.
For objectively measuring the obliquity of the exiting nerve root, we have described an angle which the exiting nerve root makes with the body of a vertebra. We will select far lateral sagittal T2 weighted image just lateral to the facet joints or the image which clearly shows exiting nerve roots coming out of intervertebral foramen in an inverted teardrop manner. We will draw a line parallel to the lower endplate of the vertebra and another line along the exiting nerve root and will measure the angle between these two lines. This we will consider ‘Angle of the obliquity of the exciting nerve root’
We will study the correlation of this obliquity of exiting nerve root on lateral sagittal MRI images with spondylolisthesis on standing lumbosacral spine lateral flexion-extension X-rays.
Statistically, we will find out (1) the sensitivity of our test, (2) the specificity of our test, (3) the predictive value of a positive test, and (4) the predictive value of a negative test.
We may thus be able to prove the correlation between obliquity of the exiting nerve root on MRI and spondylolisthesis on flexion-extension X-rays.
If it can be established then it will become a sign on MRI to diagnose spondylolisthesis with great accuracy and will obviate the need for additional investigation, i.e. lateral flexion-extension X-ray of the lumbosacral spine which at present is considered to be the gold standard to diagnose spondylolisthesis.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Yet Recruiting
- Sex
- All
- Target Recruitment
- 200
- 1.)Patients with backache and leg pain.
- 2.)Patients with lumbosacral radiculopathy.
- Patients who cannot cooperate for study 1.)Patients x-Ray with implants in spine.
- 2.)Patients who have trauma, infection, tumor as a cause of their lumbosacral radiculopathy.
- 3.)Patients who have undergone lumbosacral spine surgery with stabilization.
Study & Design
- Study Type
- Observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method 1.)Angle of obliquity of the exiting nerve root. at baseline 2.) Presence/absence of spondylolisthesis at baseline
- Secondary Outcome Measures
Name Time Method the sensitivity of the test, the specificity of the test, the predictive value of a positive test, and the predictive value of a negative test. at baseline
Trial Locations
- Locations (1)
Balwant Institute of Neurosciences and Intensive Trauma care
🇮🇳Solapur, MAHARASHTRA, India
Balwant Institute of Neurosciences and Intensive Trauma care🇮🇳Solapur, MAHARASHTRA, IndiaDr DB KatikarPrincipal investigator9822072410drkatikar@gmail.com