PURPOSE: To evaluate the effect of compressive axial loading in imaging of the lumbar spine in patients with clinically suspected spinal stenosis. MATERIAL AND METHODS: A total of 84 patients were examined, 50 with CT (after intrathecal contrast administration) and 34 with MR. First the dural sac cross-sectional area (CSA) was determined with the patient in the supine psoas relaxed position (PRP). Then the CSA was determined during supine axial compression in slight extension (ACE), obtained with a specially designed loading device. A measurement error study was performed. RESULTS: A minimum difference in CSA of 15 mm2 between PRP and ACE was found to be significant. In 40/50 (80%) of CT-examined patients and in 26/34 (76%) of MR-examined patients a significant difference in CSA was found. In 25/84 (30%) of the patients there was a significant difference at more than one level. CONCLUSION: For an adequate evaluation of the CSA, CT or MR studies should be performed with axial loading in patients who have symptoms of lumbar spinal stenosis.
PURPOSE: To evaluate the effect of compressive axial loading in imaging of the lumbar spine in patients with clinically suspected spinal stenosis. MATERIAL AND METHODS: A total of 84 patients were examined, 50 with CT (after intrathecal contrast administration) and 34 with MR. First the dural sac cross-sectional area (CSA) was determined with the patient in the supine psoas relaxed position (PRP). Then the CSA was determined during supine axial compression in slight extension (ACE), obtained with a specially designed loading device. A measurement error study was performed. RESULTS: A minimum difference in CSA of 15 mm2 between PRP and ACE was found to be significant. In 40/50 (80%) of CT-examined patients and in 26/34 (76%) of MR-examined patients a significant difference in CSA was found. In 25/84 (30%) of the patients there was a significant difference at more than one level. CONCLUSION: For an adequate evaluation of the CSA, CT or MR studies should be performed with axial loading in patients who have symptoms of lumbar spinal stenosis.
Authors: Akio Hiwatashi; Barbro Danielson; Toshio Moritani; Robert S Bakos; Thomas G Rodenhause; Webster H Pilcher; Per-Lennart Westesson Journal: AJNR Am J Neuroradiol Date: 2004-02 Impact factor: 3.825
Authors: H Ozawa; H Kanno; Y Koizumi; N Morozumi; T Aizawa; T Kusakabe; Y Ishii; E Itoi Journal: AJNR Am J Neuroradiol Date: 2012-02-09 Impact factor: 3.825