Supine spinal magnetic resonance imaging with straightened lower extremities in spondylolisthesis: A comparison with the conventional technique

Daghighi, Mohammad Hossein; Poureisa, Masoud; Arablou, Farid; Fouladi, Daniel Fadaei

doi:10.1016/j.ejrad.2015.01.023

Cited by 6 publications

(5 citation statements)

References 37 publications

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“…All patients undergoing MRI in supine position had a 60°-angle pillow under their knees to make lying on the back more comfortable. A recent study has shown a higher degree of slippage in symptomatic patients with spondylolisthesis in supine magnetic resonance imaging with straightened lower extremities than in conventional MRI with flexed lower extremities [21]. Changes in lumbar lordosis due to knee flexion have been controversially discussed in the literature.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Lumbar Lordosis in Lateral Radiographs in Standing Position with supine MR Imaging in consideration of the Sacral Slope

Benditz¹,

Boluki²,

Weber³

et al. 2016

Fortschr Röntgenstr

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ZUSAMMENFASSUNGZiel Ziel dieser retrospektiven Studie war es, den Einfluss des "Sacral Slope" auf den Zusammenhang zwischen der gemessenen lumbalen Lordose in lateralen Röntgenaufnahmen der Wirbelsäule im Stehen und liegenden MRT Aufnahmen zu untersuchen. Dieser Zusammenhang ist in der Literatur weitgehend unbekannt. Bisherige Studien haben Zusammenhänge für die thorakale Wirbelsäule gezeigt, jedoch nicht für die lumbalen Anteile. Methods MR images and standing lateral radiographs of 63 patients without actual low back pain or radiographic pathologies of the lumbar spine were analyzed. Standing radiographic measurements included the sagittal parameters pelvic incidence (PI) pelvic tilt (PT), and sacral slope (SS); MR images were used to additionally measure lumbar L1-S1 lordosis and single level lordosis. Differences between radiographic and MRI measurements were analyzed and divided into 4 subgroups of different sacral slope according to Roussouly's classification.Results Global lumbar lordosis (L1-S1) was 44.99°(± 10 754) on radiographs and 47.91°(± 9.170) on MRI, yielding a clinically relevant correlation (r = 0.61, p < 0.01). Measurements of single level lordosis only showed minor differences. At all levels except for L5 / S1, lordosis measured by means of standing Musculoskeletal System 233Benditz A et al.

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Section: Discussionmentioning

confidence: 99%

Comparison of Lumbar Lordosis in Lateral Radiographs in Standing Position with supine MR Imaging in consideration of the Sacral Slope

Benditz¹,

Boluki²,

Weber³

et al. 2016

Fortschr Röntgenstr

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show abstract

“…The change in sagittal axes at the disc level (≤3.8 degrees) was likely too small to affect these findings, despite a mean change of only 5.7 degrees in lumbar lordosis L1/S1 led to increased degree of spondylolisthesis in the study by Daghighi et al 8 Alternatively, the studied disc and nerve root findings were too minor to show appreciable change. More marked findings might perhaps have changed.…”

Section: Discussionmentioning

confidence: 80%

“…Lumbar MRI in various supine positions has revealed less bulging discs on extension and flexion views than on neutral views, 9 increased axial dural sac area if a lumbar pillow is added 10 and increased spondylolisthesis on MRI with straightened vs flexed lower limbs. 8 Patients with sciatica usually undergo MRI in the supine position with flexed hips and knees. We hypothesized that straightened hips and knees might provoke lumbar extension and pain, and might reveal disc and nerve root findings not verified on supine MRI with flexed hips and knees.…”

Section: Introductionmentioning

confidence: 99%

Disc and nerve root findings on lumbar MRI with straightened v s flexed hips and knees—pilot study

Espeland

Dalen

2019

The British Journal of Radiology

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Objective: To compare disc and nerve root findings, image quality, and pain between supine lumbar MRI positions with straightened v s flexed hips and knees. Methods: In this prospective pilot study, 14 adults with sciatica or suspected lumbar radiculopathy underwent MRI supine with their hips and knees flexed and then straightened. For each position, two experienced radiologists assessed disc contour, location/size of disc herniation, nerve root affection, image quality, image evaluation difficulty, and sagittal angles between the vertebral bodies at each disc level L3-S1. Patients scored pain (0–10) after MRI in each position. We compared MRI assessments and mean pain scores (t-test, log-transformation) between the two positions. Results: We found no clear difference in disc bulges, disc herniation, nerve root affection, image quality, or image evaluation difficulty between MRI with straightened v s flexed knees/hips. Herniation size differed ≤ 0.6 mm between the two positions. Sagittal angles between neighboring vertebral bodies differed ≤3.8°. Mean pain score after MRI with straightened v s flexed knees/hips was 4.64 v s 3.29 (p = 0.005). Conclusion: In this pilot study, supine lumbar MRI with straightened vs flexed hips/knees showed similar disc and nerve root findings. The straightened position appeared more painful. Advances in knowledge: In previous studies, spondylolisthesis increased on supine MRI with straightened v s flexed lower limbs, but corresponding data on disc findings were lacking. In this pilot study, supine lumbar MRI with straightened rather than flexed hips and knees was more painful and did not improve the diagnosis of disc or nerve root findings.

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“…38 However, some studies have indicated that similar diagnostic information can also be obtained by scanning patients in the supine position with straightened lower extremities. 9,48 Therefore, the influence of gravity and the lumbar lordosis on spondylolisthesis is not yet fully understood. 36…”

Section: Spondylolisthesis With Nerve Root Compressionsmentioning

confidence: 99%

Weight-bearing MRI of the Lumbar Spine: Spinal Stenosis and Spondylolisthesis

Hansen

Nordberg

Hansen

et al. 2019

Semin Musculoskelet Radiol

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Symptoms of degenerative lumbar spinal stenosis include back pain, radiculopathy, claudication, and muscular fatigue that tend to be predominant in the standing position or during walking. Lumbar spondylolisthesis is also a well-known cause of spinal stenosis, lateral recess, and neural foraminal narrowing that tends to become more severe in the upright position. This indicates a functional positional component of both spinal stenosis and spondylolisthesis. Lumbar spinal stenosis and spondylolisthesis are typically evaluated by magnetic resonance imaging (MRI) performed in the supine position with a pillow under the patient's lower limbs that slightly flexes the lumbar spine and ameliorates symptoms. Because these two entities tend to be aggravated in the upright position, it seems rational to also consider performing diagnostic imaging in these patients in the upright position. This article reviews the use of weight-bearing MRI for lumbar spinal stenosis and spondylolisthesis.

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Supine spinal magnetic resonance imaging with straightened lower extremities in spondylolisthesis: A comparison with the conventional technique

Cited by 6 publications

References 37 publications

Comparison of Lumbar Lordosis in Lateral Radiographs in Standing Position with supine MR Imaging in consideration of the Sacral Slope

Comparison of Lumbar Lordosis in Lateral Radiographs in Standing Position with supine MR Imaging in consideration of the Sacral Slope

Disc and nerve root findings on lumbar MRI with straightened v s flexed hips and knees—pilot study

Weight-bearing MRI of the Lumbar Spine: Spinal Stenosis and Spondylolisthesis

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