Axial Loading during MRI Induces Lumbar Foraminal Area Changes and Has the Potential to Improve Diagnostics of Nerve Root Compromise

Hebelka, Hanna,1977Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology (författare)

Lumbar foraminal stenosis is a common cause of lumbar radiculopathy and conventionally assessed with magnetic resonance imaging (MRI) in supine-positioned patients. An MRI acquired during spine loading may unmask pathology not otherwise revealed in a relaxed position. Therefore, we investigated how spine loading during MRI affects lumbar foramina. In 89 low-back pain patients’ lumbar, MRIs were performed in a relaxed supine position and during axial loading using a Dynawell® compression device. The smallest area of all intervertebral foramina at levels L3/L4–L5/S1 (534 foramina) was determined using a freehand polygonal tool in parasagittal T2-weighted sequences. The grading system described by Lee et al. was also used to qualitatively assess foraminal stenosis. Overall, a mean reduction of 2.2% (mean −0.89 cm2 and −0.87 cm2, respectively) was observed (p = 0.002), however for individual foramina large variations, with up to about 50% increase or decrease, were seen. Stratified for lumbar level, an area reduction was found for L3/L4 and L4/L5 foramina (mean change −0.03 cm2; p = 0.036; and −0.03 cm2; p = 0.004, respectively) but not for L5/S1. When comparing the measured area changes to qualitative foraminal grading, 22% of the foramina with a measured area decrease were evaluated with a higher grading. Thus, detailed information on foraminal appearance and nerve root affection can be obtained using this method.

Rydberg, NiklasGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences (författare)
Hutchins, JohnGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper,Institute of Clinical Sciences(Swepub:gu)xhuthj (författare)
Lagerstrand, Kerstin MGothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology(Swepub:gu)xlagke (författare)
Brisby, Helena,1965Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för radiologi,Institute of Clinical Sciences, Department of Radiology(Swepub:gu)xbrish (författare)
Göteborgs universitetInstitutionen för kliniska vetenskaper, Avdelningen för radiologi (creator_code:org_t)

Av författaren/redakt...: Hebelka, Hanna, ...; Rydberg, Niklas; Hutchins, John; Lagerstrand, Ker ...; Brisby, Helena, ...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Radiologi och bi ...

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