Aims and objectives
Degenerative lumbar spinal stenosis (DLSS) is the narrowing of the central vertebral canal that compresses spinal nerves in the dural sac.
Lumbar spinal canal stenosis may cause a degree of neurogenic claudication.
Supine magnetic resonance imaging (MRI) is routinely used to evaluate patients with suspected DLSS.
However,
MRI findings sometimes correlate poorly with neurological findings or patient complaints.
The assessment of these patients may be insufficient [1].
Axial-loaded lumbar MRI in supine (recumbent) position,may improve diagnostic accuracy.
Using a non-magnetic axial compression device to apply...
Methods and materials
This study was planned retrospectively between years 2008-2017.
The study included 103 consecutive patients,
presented with only neurogenic claudication and/or without low back pain.
Patients who presented with radiating leg pain and/or only low back pain without neurogenic claudication were excluded from the study groups.
There were 43 males and 60 females,
ranging in age from 21 to 75 years (mean age= 44 years).
Patients were examined in four subgroups according to their age (Table 1).
A control group for all of the age groups...
Results
A total of 188 disc levels of were assessed from 103 patients.
The distribution of a total 188 disc levels of L4-L5,
L4-L5/L5-S1 and L5-S1 are 34,
35 and 34 respectively (Table 3).
The sampling number of disc levels were selected randomly and close to each other with minimum standard deviation. The number of patients with a reduction in DSCA of more than 15 mm2 (during loading) are shown in Table 2,
for each age group (Table 4,5).
Load-induced reductions in DSCA of more than...
Conclusion
Significant changes in the lumbar DSCA from upright standing to the spine positions at L4-5 and L5-S1 using an axial loading device were observed.
Consequently,
the use of axial-loaded MRI in patients with clinically suspected lumbar spinal canal stenosis could reduce the risk of misdiagnosis of stenosis,
leading to inappropriate treatment.
Personal information
1)Hadi Sasani,
Assistant Professor,
Namik Kemal University,
Faculty of Medicine,
Department of Radiology,
Tekirdag,
Turkey.
2) Metin Vural,
Radiologist,
American Hospital,
Department of Radiology,
Istanbul,
Turkey.
3) Mehdi Sasani,
Professor,
Koc University,Faculty of Medicine,
Department ofNeurosurgery,Istanbul,
Turkey.
References
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Mariconda M,
Fava R,
Gatto A,
et al.
Unilateral laminectomy for bilateral decompression of lumbar spinal stenosis: a prospective comparative study with conservatively treated patients.
J Spinal Disord Tech.
2002;15:39-46.
2.
Willen J,
Danielson B.
The Diagnostic Effect From Axial Loading of the Lumbar Spine During Computed Tomography and Magnetic Resonance Imaging in Patients With Degenerative Disorders.
Spine 2001;26:2607–2614.
3.
Wang YC,
Jeng CM,
Wu CY,
et al.
Dynamic effects of axial loading on the lumbar spine during magnetic resonance imaging in patients with...