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Lumbar spine MRI in upright position for diagnosing acute and chronic low back pain: statistical analysis of morphological changes.

Tarantino U, Fanucci E, Iundusi R, Celi M, Altobelli S, Gasbarra E, Simonetti G, Manenti G - J Orthop Traumatol (2012)

Bottom Line: Statistically significant differences [one-way analysis of variance (ANOVA), p = 0.0043] were found between each pair of values of parameters sampled in recumbent and upright positions.In 70 % of patients, on visual qualitative analysis only, an increment of disc protrusions and/or spondylolisthesis was found in the upright position; in three cases, in the upright position only, an interarticular pseudocyst was found.Dynamic MRI with an open-configuration, low-field tilting MRI system is a feasible and promising tool to study degenerative pathology of the spine.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics and Traumatology, Tor Vergata University of Rome, Policlinico Tor Vergata Foundation, V.le Oxford 81, 00133, Rome, Italy.

ABSTRACT

Background: Patients with low back pain frequently demonstrate recumbent magnetic resonance imaging (MRI) alterations not always related to homogeneous clinical symptoms. The purpose of this study was to evaluate and quantify the statistical significance of variations of some anatomical parameters of the lumbosacral spine and reveal occult disc pathologies from recumbent to upright position in patients with acute and chronic low back pain.

Materials and methods: Fifty-seven patients complaining of low back pain (27 women, 30 men) underwent dynamic lumbosacral MRI with a 0.25-T tilting system (G-scan Esaote). We settled five parameters for which variations have been evaluated: lumbosacral angle, lordosis angle, L3-L4 intersomatic disc height, L3-L4 interspinous processes distance, and widest anteroposterior dural sac diameter. Images were obtained in both recumbent and upright positions.

Results: Statistically significant differences [one-way analysis of variance (ANOVA), p = 0.0043] were found between each pair of values of parameters sampled in recumbent and upright positions. In 70 % of patients, on visual qualitative analysis only, an increment of disc protrusions and/or spondylolisthesis was found in the upright position; in three cases, in the upright position only, an interarticular pseudocyst was found.

Conclusions: Dynamic MRI with an open-configuration, low-field tilting MRI system is a feasible and promising tool to study degenerative pathology of the spine. Moreover, in cases of low back pain with negative MRI in the recumbent position or in patients with pain in the upright position only, tilting MRI permits visualization of occult spine and disc pathologies in patients with acute or chronic low back pain.

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Statistical distribution of the intersomatic disc thickness between sexes. Average value in clinostatism 12.9 mm and orthostasis 11.2 mm
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Fig5: Statistical distribution of the intersomatic disc thickness between sexes. Average value in clinostatism 12.9 mm and orthostasis 11.2 mm

Mentions: In the supine position, lordosis angle had a mean value of 35.5° (women 35.4° ± 11.8°; men 35.5° ± 10°) and in upright position 41.6° (women 41.8° ± 12.3°; men 41.5° ± 9.1°) (ANOVA, p = 0.00097). No statistically significant difference between sexes was found (Figs. 1a, b, 4b). As previously described, intervertebral disc thickness was reduced from supine to standing position, with a mean of 12.9 mm (women 11.7 ± 2 mm; men 14.0 ± 1.8 mm) and 11.2 (women 10.0 ± 2.3 mm; men 12.1 ± 1.6 mm), respectively (ANOVA, p = 0.000083). There was a statistically significant difference between sexes (Figs. 2a, b, 5).Fig. 5


Lumbar spine MRI in upright position for diagnosing acute and chronic low back pain: statistical analysis of morphological changes.

Tarantino U, Fanucci E, Iundusi R, Celi M, Altobelli S, Gasbarra E, Simonetti G, Manenti G - J Orthop Traumatol (2012)

Statistical distribution of the intersomatic disc thickness between sexes. Average value in clinostatism 12.9 mm and orthostasis 11.2 mm
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3585839&req=5

Fig5: Statistical distribution of the intersomatic disc thickness between sexes. Average value in clinostatism 12.9 mm and orthostasis 11.2 mm
Mentions: In the supine position, lordosis angle had a mean value of 35.5° (women 35.4° ± 11.8°; men 35.5° ± 10°) and in upright position 41.6° (women 41.8° ± 12.3°; men 41.5° ± 9.1°) (ANOVA, p = 0.00097). No statistically significant difference between sexes was found (Figs. 1a, b, 4b). As previously described, intervertebral disc thickness was reduced from supine to standing position, with a mean of 12.9 mm (women 11.7 ± 2 mm; men 14.0 ± 1.8 mm) and 11.2 (women 10.0 ± 2.3 mm; men 12.1 ± 1.6 mm), respectively (ANOVA, p = 0.000083). There was a statistically significant difference between sexes (Figs. 2a, b, 5).Fig. 5

Bottom Line: Statistically significant differences [one-way analysis of variance (ANOVA), p = 0.0043] were found between each pair of values of parameters sampled in recumbent and upright positions.In 70 % of patients, on visual qualitative analysis only, an increment of disc protrusions and/or spondylolisthesis was found in the upright position; in three cases, in the upright position only, an interarticular pseudocyst was found.Dynamic MRI with an open-configuration, low-field tilting MRI system is a feasible and promising tool to study degenerative pathology of the spine.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics and Traumatology, Tor Vergata University of Rome, Policlinico Tor Vergata Foundation, V.le Oxford 81, 00133, Rome, Italy.

ABSTRACT

Background: Patients with low back pain frequently demonstrate recumbent magnetic resonance imaging (MRI) alterations not always related to homogeneous clinical symptoms. The purpose of this study was to evaluate and quantify the statistical significance of variations of some anatomical parameters of the lumbosacral spine and reveal occult disc pathologies from recumbent to upright position in patients with acute and chronic low back pain.

Materials and methods: Fifty-seven patients complaining of low back pain (27 women, 30 men) underwent dynamic lumbosacral MRI with a 0.25-T tilting system (G-scan Esaote). We settled five parameters for which variations have been evaluated: lumbosacral angle, lordosis angle, L3-L4 intersomatic disc height, L3-L4 interspinous processes distance, and widest anteroposterior dural sac diameter. Images were obtained in both recumbent and upright positions.

Results: Statistically significant differences [one-way analysis of variance (ANOVA), p = 0.0043] were found between each pair of values of parameters sampled in recumbent and upright positions. In 70 % of patients, on visual qualitative analysis only, an increment of disc protrusions and/or spondylolisthesis was found in the upright position; in three cases, in the upright position only, an interarticular pseudocyst was found.

Conclusions: Dynamic MRI with an open-configuration, low-field tilting MRI system is a feasible and promising tool to study degenerative pathology of the spine. Moreover, in cases of low back pain with negative MRI in the recumbent position or in patients with pain in the upright position only, tilting MRI permits visualization of occult spine and disc pathologies in patients with acute or chronic low back pain.

Show MeSH
Related in: MedlinePlus