Pre- and post-treatment nerve root tractography in the lumbar spine - a pilot study

  • Research type

    Research Study

  • Full title

    Nerve root tractography in the lumbar spine pre- and post surgical nerve decompression

  • IRAS ID

    169376

  • Contact name

    Bernhard Tins

  • Contact email

    Bernhard.Tins@rjah.nhs.uk

  • Duration of Study in the UK

    2 years, 4 months, 30 days

  • Research summary

    The indication for spinal intervention is partly based on objective criteria such as loss of power and partly on subjective criteria such as pain. Conventional imaging can help identify abnormal anatomy but can not directly image pain or nerve damage.
    Diffusion weighted imaging (DWI) of nerves (also called tractography) can assess nerve damage due to mechanical compromise and might enable better patient selection for spinal intervention as well as providing an objective outcome measure after the intervention.
    DWI assesses diffusion of water molecules in space. In an intact nerve diffusion mainly occurs along the long axis of the nerve, in damaged nerves diffusion is increased in the radial directions.
    It is proposed to perform DWI before and 3 months after nerve decompression spinal surgery and to assess the change in diffusion parameters of affected spinal nerves. DWI changes of the nerves are then related to the clinical signs and symptoms before and after surgery as determined by clinical examination and questionaires.
    If successful this technique should help in patient selection prior to spinal intervention.

    patient selection: adult patients with compressive lumbar root compression, single level, are offered participation in the study
    participating patients will undergo an additional MRI scan prior to and 3 month after spinal decompression surgery
    numerical data for nerve diffusivity pre and post surgery will be correlated to the results of clinical examination and clinical scores pre and post surgery

  • REC name

    West Midlands - Black Country Research Ethics Committee

  • REC reference

    15/WM/0167

  • Date of REC Opinion

    21 May 2015

  • REC opinion

    Favourable Opinion