Can Foraminal Stenosis Due to Lumbar Isthmic Spondylolisthesis Cause Axonopathy in the Lower Extremity?

Abstract

This study aimed to investigate, using electrodiagnosis, whether foraminal stenosis due to isthmic spondylolisthesis (IS) causes peripheral nerve axonopathy. We retrospectively reviewed the medical records of the Yeungnam University Hospital and included 46 patients (mean age = 60.8 ± 13.7 years; male:female = 24:22) with foraminal stenosis due to IS. We classified foraminal stenosis grading based on T2 and T1 sagittal spinal magnetic resonance imaging (MRI). Patients were divided into mild (n = 18) and severe foraminal stenosis (n = 28) groups. To evaluate axonopathy in the lower extremity, results of compound motor action potential (CMAP) of the extensor digitorum brevis muscle (EDB) and abductor hallucis brevis muscle (AHB), and sensory nerve action potential (SNAP) of the sural nerve were retrieved. No statistically significant difference was observed in the amplitude of CMAP of the EDB and AHB and SNAP of the sural nerve with the severity of foraminal stenosis. However, age showed a statistically significant relationship with the amplitude of NCS in the EDB, AHB, and sural nerves (p < 0.001). The severity of foraminal stenosis due to IS showed no relationship with axonopathy beyond age-related degeneration of the lower extremities. Therefore, if there is robust axonopathy in lower extremities, physicians should consider pathologies other than foraminal stenosis due to IS.