Repeat Upright Positional Magnetic Resonance Imaging for Diagnosis of Disorders Underlying Chronic Noncancer Lumbar Pain

Gilbert, Jane; Wheeler, Greg R.; Kreft, Martin P.; Upadhyay, Shailesh P.; Storey, Benjamin; Spitalieri, John R.; Mick, Gregory E.; Gibbs, Richard A.

doi:10.1016/j.jmpt.2008.09.005

Cited by 9 publications

(3 citation statements)

References 13 publications

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“…More recently, an upright MRI has been emphasized to evaluate lumbar pathologies. [ 26 27 28 ] The protocol permits imaging of patients with relative contraindications (obesity, claustrophobia, severe spinal kyphosis, severe congestive heart failure, or severe chronic obstructive pulmonary disease);[ 29 ] it provides reasonable resolution without artifact[ 30 ] and it offers the potential to diagnose occult stenosis, disc protrusion, or instability because patients can be scanned in a position that elicits symptoms. [ 29 ]…”

Section: Discussionmentioning

confidence: 99%

Upright magnetic resonance imaging of the lumbar spine: Back pain and radiculopathy

Nguyen

Doan

Shabani

et al. 2016

J Craniovert Jun Spine

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Background:Lumbar back pain and radiculopathy are common diagnoses. Unfortunately, conventional magnetic resonance imaging (MRI) findings and clinical symptoms do not necessarily correlate in the lumbar spine. With upright imaging, disc pathologies or foraminal stenosis may become more salient, leading to improvements in diagnosis.Materials and Methods:Seventeen adults (10 asymptomatic and 7 symptomatic volunteers) provided their informed consent and participated in the study. A 0.6T upright MRI scan was performed on each adult in the seated position. Parameters were obtained from the L2/3 level to the L5/S1 level including those pertaining to the foramen [cross-sectional area (CSA), height, mid-disc width, width, thickness of ligamentum flavum], disc (bulge, height, width), vertebral body (height and width), and alignment (lordosis angle, wedge angle, lumbosacral angle). Each parameter was compared based on the spinal level and volunteer group using two-factor analysis of variance (ANOVA). Bonferroni post hoc analysis was used to assess the differences between individual spinal levels.Results:Mid-disc width accounted for 56% of maximum foramen width in symptomatic volunteers and over 63% in asymptomatic volunteers. Disc bulge was 48% greater in symptomatic volunteers compared to asymptomatic volunteers. CSA was generally smaller in symptomatic volunteers compared to asymptomatic volunteers, particularly at the L4-L5 and L5-S1 spinal levels. Thickness of ligamentum flavum (TLF) generally increased from the cranial to caudal spinal levels where the L4-L5 and L5-S1 spinal levels were significantly thicker than the L1-L2 spinal level.Conclusions:The data implied that upright MRI could be a useful diagnostic option, as it can delineate pertinent differences between symptomatic volunteers and asymptomatic volunteers, especially with respect to foraminal geometry.

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Section: Discussionmentioning

confidence: 99%

Upright magnetic resonance imaging of the lumbar spine: Back pain and radiculopathy

Nguyen

Doan

Shabani

et al. 2016

J Craniovert Jun Spine

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“…These techniques require the patient to stay still for a period of time in specific positions [33–36]. These imaging devices have the negative noise of a regular MRI.…”

Section: Resultsmentioning

confidence: 99%

Evaluation of Diagnosis Techniques Used for Spinal Injury Related Back Pain

Janssen

Nabih

Moussa

et al. 2011

Pain Research and Treatment

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Back pain is a prevalent condition affecting much of the population at one time or the other. Complications, including neurological ones, can result from missed or mismanaged spinal abnormalities. These complications often result in serious patient injury and require more medical treatment. Correct diagnosis enables more effective, often less costly treatment methods. Current diagnosis technologies focus on spinal alterations. Only approximately 10% of back pain is diagnosable, with current diagnostic technologies. The objective of this paper is to investigate and evaluate based on specific criteria current diagnosis technique. Nine diagnostic techniques were found in the literature, namely, discography, myelography, single photon emission computer tomography (SPECT), computer tomography (CT), combined CT & SPECT, magnetic resonance imaging (MRI), upright and kinematic MRI, plain radiography and cineradiography. Upon review of the techniques, it is suggested that improvements can be made to all the existing techniques for diagnosing back pain. This review will aid health service developers to focus on insufficient areas, which will help to improve existing technologies or even develop alternative ones.

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“…Our patient’s most uncomfortable daytime position for LBP was sitting. The lumbar disc space pressure is highest in the sitting position, thus putting increased physical and gravitational stress on the patient’s annular tissue and endplates, thus causing mechanical stretch of nociceptors in these areas [20]. …”

Section: Discussionmentioning

confidence: 99%

Early adolescent lumbar intervertebral disc injury: a case study

Carter

Amorin-Woods

Doss³

2013

Chiropr Man Therap

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This article describes and discusses the case of an adolescent male with lumbar intervertebral disc injury characterized by chronic low back pain (LBP) and antalgia. A 13-year-old boy presented for care with a complaint of chronic LBP and subsequent loss of quality of life. The patient was examined and diagnosed by means of history, clinical testing and use of imaging. He had showed failure in natural history and conservative management relief in both symptomatic and functional improvement, due to injury to the intervertebral joints of his lower lumbar spine. Discogenic LBP in the young adolescent population must be considered, particularly in cases involving even trivial minor trauma, and in those in which LBP becomes chronic. More research is needed regarding long-term implications of such disc injuries in young people, and how to best conservatively manage these patients. A discussion of discogenic LBP pertaining to adolescent disc injury is included.

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Repeat Upright Positional Magnetic Resonance Imaging for Diagnosis of Disorders Underlying Chronic Noncancer Lumbar Pain

Cited by 9 publications

References 13 publications

Upright magnetic resonance imaging of the lumbar spine: Back pain and radiculopathy

Upright magnetic resonance imaging of the lumbar spine: Back pain and radiculopathy

Evaluation of Diagnosis Techniques Used for Spinal Injury Related Back Pain

Early adolescent lumbar intervertebral disc injury: a case study

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