Diagnostic Benefits of Axial-Loaded Magnetic Resonance Imaging Over Recumbent Magnetic Resonance Imaging in Obese Lower Back Pain Patients

Lorenc, Tomasz; Palczewski, Piotr; Wójcik, Damian; Glinkowski, Wojciech; Gołębiowski, Marek

doi:10.1097/brs.0000000000002532

Cited by 8 publications

(6 citation statements)

References 32 publications

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“…alMRI of the lumbar spine was introduced to simulate physiologic loading of the spine in the standing position to improve the diagnostic performance of MRI, which is usually performed in the supine position ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

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Magnetic Resonance Imaging Evaluation of Biomechanical Effects of Axial Loading on the Lumbar Spine

Šehić¹,

Julardžija²,

Bulja³

et al. 2022

Acta Inform Med

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Background: MRI techniques of the lumbar spine have not provided data on the effect of gravity on the spine and on the relationship of anatomic structures during its action. Because conventional MRI examinations of the spine are usually performed in the supine position these are often exacerbated by standing upright and are not evident in the supine position the loading conditions differ from those known to cause symptoms in patients with lumbar instability. Axial loading imaging may improve diagnostics in the clinical management of LBP and lead to appropriate treatment decisions. Objective: The aim of this study is to determine the significance of alMRI in detecting the morphologic changes of the lumbar spine caused by axial loading and to compare it with conventional MRI images of the lumbar spine without loading. Methods: The study was conducted as a prospective, descriptive clinical trial. Imaging was performed with a MRI 1.5 T in the head-first supine position. Imaging was performed in two acts: without load and under load. Loading for alMRI was performed with the DynaWell L-Spine device. The onset of loading was 10 minutes before the start of alMRI. The loading continued throughout the imaging procedure. The height of the IV, AP and LL diameters of IV, IV disk surface area, DSCA and width of the IV foraminas before and under load was measured. Results: After evaluating the changes in the height and size of the lumbar disks, the size of the DSCA, and the narrowing of the intervertebral foramina significant differences were found between the images before and after axial loading. Conclusion alMRI provides information on morphological changes of all segments of the lumbar spine. This data represents significant information that can lead to more accurate and effective treatment of LBP.

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Section: Discussionmentioning

confidence: 99%

“…Axial loading imaging may improve diagnostics in the clinical management of LBP and lead to appropriate treatment decisions ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging Evaluation of Biomechanical Effects of Axial Loading on the Lumbar Spine

Šehić¹,

Julardžija²,

Bulja³

et al. 2022

Acta Inform Med

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“…axial-loaded MRI) as a tool for the diagnosis of lumbar spinal stenosis when the findings of conventional supine MRI do not match the clinical signs of stenosis evident in some patients. Several studies confirm that such axial loading devices can add valuable information (especially in patients with neurogenic claudication), impact the treatment plan for degenerative disorders (1,2), increase the specificity of a diagnosis of spinal stenosis (3)(4)(5), and reveal both changes of dural sac size (3) and decreases in disc height (6).…”

Section: Introductionmentioning

confidence: 97%

Lumbosacral spinal compression device with the use of a cushion back support in supine MRI

et al. 2020

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Background We hypothesized that axial-loaded magnetic resonance imaging (MRI), modified with the use of a cushion placed behind the lower back (i.e. BS-MRI method), would simulate the standing position more accurately than an axial-loaded MRI without a cushion back support (BS). Purpose To determine whether the BS-MRI method demonstrated similar morphologies on intervertebral disc (IVD), dural sac, and spinal curvature as those detected on 90° standing MRIs in individuals with suspected spinal stenosis. Material and Methods Twenty-five subjects underwent a BS-MRI, as well as axial-loaded and standing MRI studies. Outcome measures were four radiographic parameters of the lumbar spine: IVD height (DH); dural sac cross-sectional area (DCSA); and spinal curvature (i.e. lumbar lordosis [LL] and L1-L3-L5 angle [LA]). Results Major differences (>5%) between standing MRI and BS-MRI methods were observed in DCSA, DH, and LL. Major differences between standing and axial loaded MRIs were observed only in DCSA and LA. Although BS-MRIs demonstrate an image of the lumbar spine curvature (i.e. LA) which is closer to that when standing than axial-loaded MRIs, it is likely to overestimate both narrowing of dural sac and extent of LL. Conclusion Using a compression device with a BS to simulate weight-bearing on the lumbar spine is not recommended due to: (i) overestimation of the narrowing of the dural sac and extent of LL; and (ii) underestimation of loss of disc height. Supine axial-loading produced DCSA and DH which were strongly correlated with those detected with standing MRIs. Exceptions were that LL and LA were underestimated.

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“…To generate axial loading of the lumbar spine during MRI performed in supine position, a lumbosacral spinal compression device was developed. Several studies have compared supine MRI with and without the use of axialloading devices (14,(16)(17)(18)(19)(20)(21)(22). Others have compared supine axial-loaded computed tomography (CT) (23) or MRI (7,16,24,25), with studies done while standing with conventional radiograph (23)(24)(25), upright myelogram (7), or routine standing MRI (16).…”

Section: Introductionmentioning

confidence: 99%

Axial loading during supine MRI for improved assessment of lumbar spine: comparison with standing MRI

et al. 2021

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Background There are no studies comparing the morphologic changes of lumbar spines between supine axial-loaded and 90° standing magnetic resonance imaging (MRI) examinations of patients with spinal stenosis. Purpose To determine whether axial-loaded MRI using a compression device demonstrated similar morphology of intervertebral disc, dural sac, and spinal curvature as those detected by 90° standing MRI in individuals with suspected spinal stenosis. Material and Methods A total of 54 individuals suspected of having spinal stenosis underwent both axial-loaded and standing MRI studies. The outcome measures included seven radiologic parameters of the lumbar spine: measures of the intervertebral disc (i.e. cross-sectional area [DA], disc height [DH], and anteroposterior distance [DAP]), dural sac (cross-sectional area [DCSA]), spinal curvature (i.e. lumbar lordosis [LL] and L1-L3-L5 angle [LA]), and total lumbar spine height (LH). Results For agreement between the two methods, intraclass correlation coefficient (ICC) ≥ 0.8 was found for all seven radiologic parameters. Supine axial-loaded MRI underestimated LL but remained correlated (ICC = 0.83) with standing MRI. Minor differences between the two methods (≤5.0%) were observed in DA, DCSA, DAP, LA, and LH, while a major difference was observed in LL (8.1%). Conclusion Using a compression device with the conventional supine MRI to simulate weight-bearing on the lumbar spine generated MRI morphology, which was strongly correlated with those from a standing MRI.

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Diagnostic Benefits of Axial-Loaded Magnetic Resonance Imaging Over Recumbent Magnetic Resonance Imaging in Obese Lower Back Pain Patients

Abstract: 4.

Cited by 8 publications

References 32 publications

Magnetic Resonance Imaging Evaluation of Biomechanical Effects of Axial Loading on the Lumbar Spine

Magnetic Resonance Imaging Evaluation of Biomechanical Effects of Axial Loading on the Lumbar Spine

Lumbosacral spinal compression device with the use of a cushion back support in supine MRI

Axial loading during supine MRI for improved assessment of lumbar spine: comparison with standing MRI

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