ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2017
Reversibility of nerve root sedimentation sign in lumbar spinal stenosis patients after decompression surgery.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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9 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- Use and misuse of the sedimentation sign in lumbar spine stenosis.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Pooled it
- Important postoperative magnetic resonance imaging findings correlated with clinical outcomes to evaluate adequacy and success of decompression surgery-what radiologists need to know: a systematic review.Asian spine journal · 2026Article
- Diagnostic efficacy of nerve root sedimentation sign in post-lumbar interbody fusion patients: an imaging evaluation and modification.Journal of orthopaedic surgery and research · 2025Article
- Epidural pressure measurement using a fiber-optic sensor (proof-of-principle in vivo animal trial).Animal models and experimental medicine · 2024Article
- The Correlation Between Negative Nerve Root Sedimentation Sign and Gravity: A Study of Upright Lumbar Multi-Positional Magnetic Resonance Images.Global spine journal · 2023Article
- [Lumbar spinal stenosis].Orthopadie (Heidelberg, Germany) · 2022Article
- Fusion Surgery for Lumbar Spinal Stenosis: WFNS Spine Committee Recommendations.World neurosurgery: X · 2020Article
- Usefulness of the Inferior Articular Process's Cross-Sectional Area as a Morphological Parameter for Predicting Central Lumbar Spinal Stenosis.Journal of clinical medicine · 2020Article
- [Research progress on nerve root sedimentation sign of lumbar spinal stenosis].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2019Article
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Authors and funding
6 authors at 5 institutions in 3 countries.
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No grant is acknowledged in the PubMed record.
Abstract
purposeThe nerve root sedimentation sign (SedSign) is a magnetic resonance imaging (MRI) sign for the diagnosis of lumbar spinal stenosis (LSS). It is included in the assessment of LSS to help determine whether decompression surgery is indicated. Assessment of the reversibility of the SedSign after surgery may also have clinical implications for the decision about whether or not a secondary operation or revision is needed. This study investigated if lumbar decompression leads to a reversal of the SedSign in patients with LSS and a positive SedSign pre-operatively; and if a reversal is associated with more favourable clinical outcomes. If reversal of the SedSign is usual after sufficient decompression surgery, a new positive SedSign could be used as an indicator of new stenosis in previously operated patients.
methodsA prospective cohort study of 30 LSS patients with a positive pre-operative SedSign undergoing decompression surgery with or without instrumented fusion was undertaken to assess the presence of nerve root sedimentation (=negative SedSign) on MRI at 3 months post-operation. Functional limitation (Oswestry Disability Index, ODI), back and leg pain (Visual Analogue Scale, VAS), and treadmill walking distance were also compared pre- and 3 months post-operatively. The short follow-up period was chosen to exclude adjacent segment disease and the potential influence of surgical technique on clinical outcomes at longer follow-up times.
results30 patients [median age 73 years (interquartile range (IQR) 65-79), 16 males] showed a median pre-operative ODI of 66 (IQR 52-78), a median VAS of 8 (IQR 7-9), and a median walking distance of 0 m (IQR 0-100). Three months post-operation 27 patients had a negative SedSign. In this group, we found improved clinical outcomes at follow-up: median post-operative ODI of 21 (IQR 12-26), median VAS of 2 (IQR 2-4), and median walking distance of 1000 m (IQR 500-1000). These changes were all statistically significant (p < 0.001). Three patients had a positive SedSign at 3-month follow-up due to epidural fat (n = 2) or a dural cyst following an intra-operative dural tear (n = 1), but also showed improvements in clinical outcomes for ODI, VAS and walking distance.
conclusionThe reversibility of a pre-operative positive SedSign was demonstrated after decompression of the affected segmental level and associated with an improved clinical outcome. A persisting positive SedSign could be the result of incomplete decompression or surgical complications. A new positive SedSign after sufficient decompression surgery could be used as an indicator of new stenosis in previously operated patients.
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