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Dynamic MR in patients affected by neurogenical claudication: technique and results from a single-center experience

  • Diagnostic Neuroradiology
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Abstract

Introduction

This study aimed to determine changes in size of lumbar spinal canal and related articular structures, during dynamic MR scans acquired in symptomatic patients standing upright using a new open MR system.

Methods

Forty patients (mean age 58.4 years) affected by lumbar back pain associated with claudication, referring symptoms since more than 6 months. No one underwent to previous spine surgery. MR scans were performed with a novel open 0.5-T scanner, patient supine and upright (90°). Lumbar lordotic angle, flavum ligament thickness, herniated discs, spinal canal area, spinal canal and dural sac antero-posterior diameters, and spinal alignment were measured and compared in both supine and upright positions. Mean scanning time was 43 min.

Results

All the considered parameters showed a statistically significant difference, except for lumbar lordotic angle. Mean percentage differences moving from supine to upright were +3.9 % for lumbar lordotic angle, +15 % for flavum ligament thickness, +16.2 % for sagittal disc bulge, −10.8 % for dural sac diameter, −13.1 % for spinal canal diameter, and −15.8 % for spinal canal area. In supine position, no patient presented with spondylolisthesis; moving to upright position, four patients showed spondylolisthesis (grade I).

Conclusion

Dynamic MR is a valuable diagnostic exam to analyze the structures involved in lumbar back pain due to spinal canal stenosis and spondylolisthesis; in supine position, relevant factors can be underestimated or hidden, becoming appreciable only patient standing upright. In this series, flavum ligament thickening presented a role comparable to disc bulge for narrowing of lumbar spinal canal.

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Authors and Affiliations

  1. Neuroradiology Department, Cardarelli Hospital, Naples, Italy

    Mario Muto, Gianluigi Guarnieri, Fabio Zeccolini & Alvaro Diano

  2. Radiology Department, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo 200, 00100, Rome, Italy

    Francesco Giurazza

  3. Emicenter European Medical Imaging, Casavatore, Naples, Italy

    Rossana Senese

  4. Measurement and Biomedical Instrumentation Laboratory, Università Campus Bio-Medico di Roma, Rome, Italy

    Emiliano Schena

Authors
  1. Mario Muto
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  2. Francesco Giurazza
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  3. Gianluigi Guarnieri
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  4. Rossana Senese
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  5. Emiliano Schena
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  6. Fabio Zeccolini
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  7. Alvaro Diano
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Corresponding author

Correspondence to Francesco Giurazza.

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Compliance with ethical standards

We declare that all human and animal studies have been approved by the institutional review board of Cardarelli Hospital, Naples, Italy, and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

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We declare that we have no conflict of interest.

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Muto, M., Giurazza, F., Guarnieri, G. et al. Dynamic MR in patients affected by neurogenical claudication: technique and results from a single-center experience. Neuroradiology 58, 765–770 (2016). https://doi.org/10.1007/s00234-016-1697-7

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  • DOI: https://doi.org/10.1007/s00234-016-1697-7

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