European Spine Journal

, Volume 28, Issue 4, pp 849–854 | Cite as

Identification of abnormalities in the lumbar nerve tract using diffusion-weighted magnetic resonance neurography

  • Hiroaki Manabe
  • Toshinori SakaiEmail author
  • Ryo Miyagi
  • Fumitake Tezuka
  • Kazuta Yamashita
  • Yoichiro Takata
  • Koichi Sairyo
Original Article



Abnormalities of the lumbar nerve tract caused by congenital variations or high nerve root take-off angles are difficult to visualize. Diffusion-weighted magnetic resonance neurography (DW-MRN) has recently been introduced for imaging of the lumbosacral region. The aims of this study were to identify lumbar nerve tract abnormalities caused by congenital variation or a high nerve root take-off angle using DW-MRN and to assess the diagnostic value of this imaging modality.


A total of 573 magnetic resonance images from 575 patients (261 men, 314 women; mean age 58.5 years) with low back/leg pain were retrospectively analyzed. We classified congenital variations in the lumbar nerve roots using the Neidre and MacNab criteria and investigated nerve roots with a take-off angle of 60° or more.

Results and discussion

Congenital variations were identified in 8 patients (9 nerve roots, 1.6%). The most commonly identified variation was in the sacral nerve root (n = 5) followed by the L4 (n = 3) and L5 (n = 1) nerve roots. All variations identified were on the left side. There were 3 cases of type 1a variation, 1 of type 1b, 1 of type 2, and 4 of type 3. In total, 210 (36.6%) of the magnetic resonance images showed high nerve root take-off angles at the intervertebral foramen that was caused by disk herniation, spondylolisthesis, or osteophytes with degeneration. Patients with high nerve root take-off angles were significantly older than those without (P < 0.05).

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


MRI Diffusion-weighted magnetic resonance neurography Lumbar nerve Nerve root anomaly 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

586_2018_5867_MOESM1_ESM.pptx (671 kb)
Supplementary material 1 (PPTX 670 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Hiroaki Manabe
    • 1
  • Toshinori Sakai
    • 1
    Email author
  • Ryo Miyagi
    • 1
  • Fumitake Tezuka
    • 1
  • Kazuta Yamashita
    • 1
  • Yoichiro Takata
    • 1
  • Koichi Sairyo
    • 1
  1. 1.Department of Orthopedics, Institute of Biomedical SciencesTokushima University Graduate SchoolTokushimaJapan

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