CT myelogram may identify additional stenotic levels in patients with multilevel stenosis
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CT myelogram may demonstrate additional stenotic levels among patients with multilevel stenosis on MRI but not in patients with no or single-level stenosis, according to results presented here.
Benjamin M. Weisenthal, MD, and colleagues categorized 258 patients with stenosis, spondylolisthesis or degenerative scoliosis into the following three groups: patients who had a clinical diagnosis of single-level stenosis (group 1); patients who had a clinical diagnosis of multilevel stenosis (group 2); and patients who had a clinical diagnosis of stenosis and symptoms of claudication but no levels of moderate or severe stenosis noted on MRI (group 3). All patients had an MRI or CT myelogram within 6 months with each level recorded as mild, moderate or severe.
“Mild showed some clear separation of the cauda equina. Moderate had some cauda equina aggregation, and severe showed the cauda equina as one bundle,” Weisenthal said in his presentation at the North American Spine Society Annual Meeting.
Weisenthal noted 207 patients had at least one level of moderate or severe stenosis on MRI, of whom 139 patients had multilevel stenosis and 86 patients had single-level stenosis. Of the 139 patients with multilevel stenosis, CT myelogram revealed an additional stenotic level in 80 patients, according to Weisenthal.
“By that we mean that on the MRI they had a mild or moderate level which then progressed to moderate or severe on the CT myelogram,” Weisenthal said.
He added CT myelogram revealed an additional stenotic level among 27 of 68 patients with single-level stenosis.
“In the group of 51 patients who had symptoms of claudication but they didn’t have any stenosis, we found that in only three of them did CT myelogram demonstrate an additional stenotic level after an MRI,” Weisenthal said.
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Weisenthal BM, et al. Paper 144. Presented at: North American Spine Society Annual Meeting. Sept. 29 - Oct. 2, 2021; Boston (hybrid meeting).
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