The effectiveness of the Weight-Bearing MRI in determining the optimal final surgical protocols for the patients with spinal disorders

Congress:

ESSR 2018

Poster Number:

P-0027

Type:

Scientific Poster

Keywords:

Outcomes, Equipment, Diagnostic procedure, MR-Functional imaging, MR, Musculoskeletal spine

Authors:

H.-S. Kim, G. Choi, W. H. Kim, H. J. Ma; POHANG/KR

DOI:

10.1594/essr2018/P-0027

DOI-Link:

https://dx.doi.org/10.1594/essr2018/P-0027

Fig. 2: Dynamic MR with G-Scan: Widening of the C4-5, C5-6 interspinous spaces /...

Fig. 3: Pre-op. CT and conventional MR : ADR state with metal artifact, degenerative...

Fig. 4: Supine and W-B ( Weight-Bearing) MR with G-Scan : Decreased metal artifact,...

Fig. 5: After C4-5, C5-6 post. Fusion surgery.

Purpose

Introductionand Background: Degenerative spinal disorder such as spinal stenosis or disc herniation (with neck and back pain, cervical and lumbar radicular pain etc.) is one of the most common medical and surgical problems with a prevalence ranging from 60 to 90%.(1,2,3). Stenosis of the lumbar spinal canal may cause low back pain, sciatica, and neurogenic claudication. Pressure on the spinal cord and nerve roots associated with spinal degeneration may be caused by disc displacement or herniation; spinal stenosis, a narrowing of the spinal canal; or...

Methods and Materials

From Dec. 2016 to Dec. 2017, 259 patients with clinical symptoms of spinal lesions underwent W-B MR imaging with G-Scan. We selected the 163 cases who underwent surgery. M:F=76:87 Age :28 to 87 years, mean=62.3 years. W-B MRI system : 0.25T open MRI-scanner (G-scan, ESAOTE, Genova, Italy). The scanner and patient can be positioned at any angle from 0˚to 90˚ (11). ** W-B MRI (163 pts.) 5 patients: Cervical spine 10 patients: Thoracic / Thoraco-Lumbar junction 148 patients: Lumbar spine * Exclusion : Tumor condition,...

Results

* Operation: Among the 163 patients Endoscopic decompression : 15 pts. Simple decompression : 23 pts. Interspinous locker device insertion(soft fixation) with/without decompression : 99 pts Interbody fusion surgery with/without decompression :17 pts. Percutaneous vertebroplasty : 7 pts. * After reviewing the W-B MR, The treatment plans have been determined or modified : 78 pts. (78/163=48%) Perform the surgery with confidence : 44 pts. Another additional surgery : 22 pts. Modified (n=2) or reduced (n=10) the extent of the operation : 12 pts. Case 1....

Conclusion

Discussions and Summary: *Limitations of this study: Not a long-term evaluation study ( recent launching of the weight-bearing MR). Lack of objective study for evaluating the stenosis grading system. Lack of the protocols for the image acquisition for the W-B study yet.(T1WI, T2WI and 3-D HYCE). Lack of statistical analysis. However, it is an attempt to research the usefulness of the W-B MRI in terms of clinical out-come after treatment/operation systematically (investigate the correlative findings of the patients’ symptoms and signs). The dedicated W-B MRI...

References

Vertical weight-bearing MRI provides an innovative method for standardizing Spurling test. J Yan, Y Wang, X Liu, Z Jin, Z Zheng. Med Hypotheses 2010;75:538-540 Changes in the Lumbar Spine of Athletes From Supine to the True-Standing Position in Magnetic Resonance Imaging. F Mauch, C Jung, J Huth, G Bauer. Spine 2010;35:1002-1007 Occult neural foraminal stenosis caused by association between disc degeneration and facet joint osteoarthritis: demonstration with dedicated upright MRI system. A Splendiani, F Ferrari, A Barile, C Masciocchi, M Gallucci. Radiol med 2014;119:64-174 Axial...

Personal Information

Hyung Seok, Kim, M.D. 1, Gun Choi, M.D. 2, Wook Ha, Kim, M.D. 3, Hyun Jin, Ma, M.D. 4 Dept. of Radiology 1, Dept. of Neurosurgery, 2,3,4 Pohang Wooridul Hospital, Pohang City, Korea, REP. of. Asia-Pacific research center of Weight-bearing MR Hyung Seok, Kim, M.D. E-mail : [email protected]