{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T03:33:04Z","timestamp":1783567984017,"version":"3.55.0"},"reference-count":67,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T00:00:00Z","timestamp":1721606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Introduction: Lumbar foraminal stenosis (LFS) occurs primarily due to degenerative changes in older adults, affecting the spinal foramina and leading to nerve compression. Characterized by pain, numbness, and muscle weakness, LFS arises from structural changes in discs, joints, and ligaments, further complicated by factors like inflammation and spondylolisthesis. Diagnosis combines patient history, physical examination, and imaging, while management ranges from conservative treatment to surgical intervention, underscoring the need for a tailored approach. Materials and Methods: This multicenter study, conducted over six years at a tertiary hospital, analyzed the volumetric dimensions of lumbar foramina and their correlation with nerve structures in 500 patients without lumbar pathology. Utilizing high-resolution MRI with a standardized imaging protocol, eight experienced researchers independently reviewed the images for accurate measurements. The study emphasized quality control through the calibration of measurement tools, double data entry, validation checks, and comprehensive training for researchers. To ensure reliability, interobserver and intraobserver agreements were analyzed, with statistical significance determined by kappa statistics and the Student\u2019s t-test. Efforts to minimize bias included blinding observers to patient information and employing broad inclusion criteria to mitigate referral and selection biases. The methodology and findings aim to enhance the understanding of normal lumbar foramina anatomy and its implications for diagnosing and treating lumbar conditions. Results: The study\u2019s volumetric analysis of lumbar foramina in 500 patients showed a progressive increase in foraminal volume from the L1\/L2 to the L5\/S1 levels, with significant enlargement at L5\/S1 indicating anatomical and biomechanical complexity in the lumbar spine. Lateral asymmetry suggested further exploration. High interobserver and intraobserver agreement levels (ICC values of 0.91 and 0.95, respectively) demonstrated the reliability and reproducibility of measurements. The patient cohort comprised 58% males and 42% females, highlighting a balanced gender distribution. These findings underscore the importance of understanding foraminal volume variations for lumbar spinal health and pathology. Conclusion: Our study significantly advances spinal research by quantifying lumbar foraminal volumes, revealing a clear increase from the L1\/L2 to the L5\/S1 levels, indicative of the spine\u2019s adaptation to biomechanical stresses. This provides clinicians with a precise tool to differentiate between pathological narrowing and normal variations, enhancing the detection and treatment of lumbar foraminal stenosis. Despite limitations like its cross-sectional design, the strong agreement in measurements underscores the method\u2019s reliability, encouraging future research to further explore these findings\u2019 clinical implications.<\/jats:p>","DOI":"10.3390\/medsci12030034","type":"journal-article","created":{"date-parts":[[2024,7,22]],"date-time":"2024-07-22T12:20:38Z","timestamp":1721650838000},"page":"34","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Quantifying Lumbar Foraminal Volumetric Dimensions: Normative Data and Implications for Stenosis\u2014Part 2 of a Comprehensive Series"],"prefix":"10.3390","volume":"12","author":[{"given":"Renat","family":"Nurmukhametov","sequence":"first","affiliation":[{"name":"2nd National Clinical Centre, Federal State Budgetary Research Institution, Russian Research Center of Surgery Named after Academician B.V. Petrovsky, 109240 Moscow, Russia"},{"name":"Department of Neurosurgery, Russian People\u2019s Friendship University, 121359 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3541-0635","authenticated-orcid":false,"given":"Manuel De Jesus","family":"Encarnacion Ramirez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Russian People\u2019s Friendship University, 121359 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Medet","family":"Dosanov","sequence":"additional","affiliation":[{"name":"2nd National Clinical Centre, Federal State Budgetary Research Institution, Russian Research Center of Surgery Named after Academician B.V. Petrovsky, 109240 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abakirov","family":"Medetbek","sequence":"additional","affiliation":[{"name":"2nd National Clinical Centre, Federal State Budgetary Research Institution, Russian Research Center of Surgery Named after Academician B.V. Petrovsky, 109240 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stepan","family":"Kudryakov","sequence":"additional","affiliation":[{"name":"2nd National Clinical Centre, Federal State Budgetary Research Institution, Russian Research Center of Surgery Named after Academician B.V. 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Sechenov First Moscow State Medical University (Sechenov University), 119991 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3451-5750","authenticated-orcid":false,"given":"Artem","family":"Gushcha","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Research Center of Neurology, 125367 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1381-8528","authenticated-orcid":false,"given":"Sabino","family":"Luzzi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7611-6539","authenticated-orcid":false,"given":"Andreina","family":"Rosario Rosario","sequence":"additional","affiliation":[{"name":"Autonomous University of Santo Domingo (UASD), Santo Domingo 10103, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2918-0264","authenticated-orcid":false,"given":"Carlos Salvador","family":"Ovalle","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National University of Mexico Hospital General, Durango 87106, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Valenzuela Mateo","sequence":"additional","affiliation":[{"name":"Department of Spine, Central Hospital of the Armed Forces, Santo Domingo 10602, Dominican Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesus","family":"Lafuente Baraza","sequence":"additional","affiliation":[{"name":"Spine Center Hospital del Mar, Sagrat Cor University Hospital, 08029 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8294-0826","authenticated-orcid":false,"given":"Juan Carlos","family":"Roa Montes de Oca","sequence":"additional","affiliation":[{"name":"Deparment of Neurosurgery, Complejo Asistencial Universitario de Salamanca, University of Salamanca, 37008 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2956-5112","authenticated-orcid":false,"given":"Carlos Castillo","family":"Rangel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Servicio of the 1ro de Octubre Hospital of the Instituto de Seguridad Servicios Sociales de los Trabajadores del Estado, Mexico City 07760, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3332-1789","authenticated-orcid":false,"given":"Salman","family":"Sharif","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Liaqat National Hospital and Medical School, Stadium Road, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"147","DOI":"10.3344\/kjp.2019.32.3.147","article-title":"Lumbar foraminal neuropathy: An update on non-surgical management","volume":"32","author":"Choi","year":"2019","journal-title":"Korean J. 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