The outcomes from spinal nerve decompression surgery are highly variable with a sizable proportion of elderly foraminal stenosis patients not regaining good pain relief. A better understanding of nerve root compression before and following decompression surgery and whether these changes are mirrored by improvements in symptoms may help to improve clinical decision-making processes. This case study used a combination of diffusion tensor imaging (DTI), clinical questionnaires and motor neurophysiology assessments before and up to 3 months following spinal decompression surgery. In this case report, a 70-year-old women with compression of the left L5 spinal nerve root in the L5-S1 exit foramina was recruited to the study. At 3 months following surgery, DTI revealed marked improvements in left L5 microstructural integrity to a similar level to that seen in the intact right L5 nerve root. This was accompanied by a gradual improvement in pain-related symptoms, mood and disability score by 3 months. Using this novel multimodal approach, it may be possible to track concurrent improvements in pain-related symptoms, function and microstructural integrity of compressed nerves in elderly foraminal stenosis patients undergoing decompression surgery.

中文翻译：

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腰椎神经的扩散张量成像揭示了减压手术后的微结构完整性变化，并伴有临床症状改善：一例。

脊柱神经减压手术的结果变化很大，相当大比例的老年人椎间孔狭窄患者不能很好地缓解疼痛。更好地了解减压手术前后的神经根受压以及这些变化是否可以通过症状的改善反映出来，可能有助于改善临床决策过程。该案例研究在脊髓减压手术之前和之后的三个月内结合使用了扩散张量成像（DTI），临床调查表和运动神经生理学评估。在该病例报告中，招募了一名70岁的L5-S1出口孔眼中左L5脊神经根受压的妇女。手术后三个月，DTI揭示了左L5微结构完整性的显着改善，其程度与完整的右L5神经根的相似。伴随着疼痛相关症状，情绪和残疾评分的改善，持续了3个月。使用这种新颖的多峰方法，可以追踪正在进行减压手术的老年有孔狭窄患者的疼痛相关症状，功能和压迫神经的微结构完整性的同时改善。