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Lumbar spine MRI in upright position for diagnosing acute and chronic low back pain: statistical analysis of morphological changes
- Source :
- Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology
- Publication Year :
- 2013
- Publisher :
- Springer Verlag, 2013.
-
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.
- Subjects :
- Adult
Male
medicine.medical_specialty
Lordosis
Settore MED/50 - Scienze Tecniche Mediche Applicate
Disc degeneration
Lumbar instability
Settore MED/36 - Diagnostica per Immagini e Radioterapia
Upright MRI
Recumbent Position
Image Processing, Computer-Assisted
Settore MED/33 - Malattie Apparato Locomotore
Humans
Medicine
Low back pain
Orthopedics and Sports Medicine
Aged
Upright MRI Novel diagnostic tool Low back pain Lumbar instability Disc degeneration
medicine.diagnostic_test
business.industry
Chronic pain
Magnetic resonance imaging
Middle Aged
Novel diagnostic tool
medicine.disease
Magnetic Resonance Imaging
Biomechanical Phenomena
Surgery
Acute Disease
Dynamic contrast-enhanced MRI
Lumbosacral angle
Female
Original Article
Radiology
Chronic Pain
medicine.symptom
business
Lumbosacral joint
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Journal :
- Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology
- Accession number :
- edsair.doi.dedup.....3fce8472d6e797f1445e61acec4b19b4