Purpose
Subcutaneos lumbar edema (SLE) is a common finding in patients undergoing lumbar MRI for differential diagnosis of lower back pain.
The aim of this study is to explore the association between subcutaneous lumbar edema and the posterior compartment degenerative disease in patients with lower back pain.
SLE is frequently observed at conventional MR imaging as a triangle-shaped area on axial images,
with T1 inhomogeneous hypointensity and T2 hyperintensity .
Particularly,
fat-suppressed (i.e.
fat saturated turbo spin echo -TSE- and short tau inversion recovery –STIR-) T2...
Methods and Materials
The lumbar MRI findings of 500 patients (mean age 61 ±16 years) with lower back pain underwent lumbar MRI using a 1.5 T magnet (Avanto,
Siemens).
Patients with associated radicular pain were excluded from the study.
The MR protocol included:
- Sagittal TSE T2- and T1- weighted images,
- Axial TSE T2-weighted images and
- Fat-suppressed TSE T2 weighted images.
Images were reviewed on the basis of MR signal for the presence of:
LSE;
Anterior compartment degenerative disease such as: Disk degeneration,
Disk bulging,
Disk...
Results
SLE was observed in 40% of patients.
No association was estimated between SLE and anterior compartment degenerative disease.
SLE was significantly associated with posterior degenerative disease (p value < 0.001) and lumbar canal stenosis (p value < 0.001) with an estimated relative risk ratio of respectively 2.1 (95% CI: 1.3-3.3) and 2.3 (95% CI: 1.6-3.4).
Conclusion
Subcutaneous lumbar edema is significantly associated to posterior compartment degenerative disease.
More further studies should detect a possible association between LSE and lumbar back pain,
to improve the clinical and therapeutical approach to patients with chronic lumbar back pain.
References
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STIR sequence for depiction of degenerative changes in posterior stabilizing elements in patients with lower back pain. AJR 2008; 191: 973-979
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Hacking JC,
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Sacral edema: computed tomographic and anatomical observations. Clin Anat 1995; 8: 56-60
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