Anatomic Assessment of L1-S1 Neuroforaminal Dimensions Using Computed Tomography in 1,000 Patients: A Follow-Up Study

Abstract

Objectives While the radiographic criteria for diagnosing central lumbar stenosis are well described, criteria for diagnosing neuroforaminal stenosis (NFS) are unclear. Prior research has utilized magnetic resonance imaging (MRI) to characterize neuroforaminal dimensions (NFDs). However, this approach has inherent limitations that can adversely impact measurement accuracy. Existing literature on the use of computed tomography (CT) to investigate normal NFDs is limited. The purpose of the present study was to describe normal lumbar NFDs that would aid in the establishment of objective quantitative criteria for the diagnosis of NFS. Methods This study evaluated CT imaging of 494 female and 506 male subjects between 18 and 35 years of age to determine normal NFDs, specifically the sagittal anteroposterior width, craniocaudal height, and area. Statistical analyses were performed to assess differences in NFDs according to variables including sex, height, weight, body mass index, and ethnicity. Results Without differentiating between sides or disc levels, mean NFDs were 8.71 mm for sagittal anteroposterior width, 17.73 mm for craniocaudal height, and 133.26 mm2 for area (n = 10,000 measurements each). Male subjects had larger NFDs than females at multiple levels. Asian and Caucasian subjects had larger NFDs than Hispanic and African American subjects at multiple levels. There were no associations between NFDs and anthropometric factors. Conclusions The present study describes normal lumbar NFDs in young, healthy patients. NFDs were influenced by sex and ethnicity but not by anthropometric factors.