Lumbar spine MRI in upright position for diagnosing acute and chronic low back pain: statistical analysis of morphological changes
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.
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. 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.
- Lumbar spine MRI in upright position for diagnosing acute and chronic low back pain: statistical analysis of morphological changes
- Open Access
- Available under Open Access This content is freely available online to anyone, anywhere at any time.
Journal of Orthopaedics and Traumatology
Volume 14, Issue 1 , pp 15-22
- Cover Date
- Print ISSN
- Online ISSN
- Springer Milan
- Additional Links
- Upright MRI
- Novel diagnostic tool
- Low back pain
- Lumbar instability
- Disc degeneration
- Industry Sectors
- Author Affiliations
- 1. Department of Orthopedics and Traumatology, “Tor Vergata” University of Rome, “Policlinico Tor Vergata” Foundation, V.le Oxford 81, 00133, Rome, Italy
- 2. Department of Diagnostic Imaging and Interventional Radiology, Molecular Imaging and Radiotherapy, “Tor Vergata” University of Rome “Policlinico Tor Vergata” Foundation, V.le Oxford 81, 00133, Rome, Italy