Advertisement

La radiologia medica

, Volume 121, Issue 1, pp 38–44 | Cite as

Magnetic resonance imaging (MRI) of the lumbar spine with dedicated G-scan machine in the upright position: a retrospective study and our experience in 10 years with 4305 patients

  • Alessandra Splendiani
  • Marco PerriEmail author
  • Giuseppe Grattacaso
  • Valeria Di Tunno
  • Claudia Marsecano
  • Luca Panebianco
  • Antonio Gennarelli
  • Valentina Felli
  • Marco Varrassi
  • Antonio Barile
  • Ernesto Di Cesare
  • Carlo Masciocchi
  • Massimo Gallucci
MAGNETIC RESONANCE IMAGING

Abstract

Purpose

To evaluate the pathological changes of the lumbar spine and the instability of the lumbar intervertebral joints observed in patients with low back pain, with the study of the transition from supine to orthostatic position through the use of dedicated MRI-G-scan machine.

Materials and Methods

Within 10 years, 4305 patients, aged between 21 and 80 years old, with history of low back pain with or without sciatica, underwent MRI examinations in upright and in supine position. The open MRI-scanner used is Esaote G-scan, which enables the acquisition of images in supine and standing positions. The used sequences were sagittal T2-weighted FSE, T1-weighted SE and axial 3D HYCE. Patients were divided into two groups: “negatives”, with no changes in the two positions (supine and upright), and “positives”, with MRI modifications of imaging in upright position.

Results

Orthostatic examination showed MRI changes in 2870 out of 4305 (66.6 %) patients, including 1252 males and 1618 females.

Conclusions

The G-scan is useful to assess instability of the lumbar spine detecting hidden modifications of protrusions and/or herniated discs already present in the supine position. It is also helpful in assessing the presence or modification of spondylolisthesis and lumbar canal stenosis.

Keywords

Low back pain Open MRI scanner 0.25 T Lumbar intervertebral instability Herniated disc 

Notes

Compliance with ethical standards

Conflict of interest

All authors declare that they no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Coste J, Paolaggi JB, Spira A (1991) Reliability of interpretation of plain lumbar spine radiographs in benign, mechanical low-back pain. Spine 16:426–428PubMedCrossRefGoogle Scholar
  2. 2.
    Kelsey JL, Hochberg MC (1988) Epidemiology of chronic musculoskeletal disorders. Annu Rev Public Health 9:379–401PubMedCrossRefGoogle Scholar
  3. 3.
    Modic MT, Pavlicek W, Weinstein MA et al (1984) Magnetic resonance imaging of intervertebral disk disease. Clinical and pulse sequence considerations. Radiology 152:103–111PubMedCrossRefGoogle Scholar
  4. 4.
    Perri M, Grattacaso G, Di Tunno V, Marsecano C, Di Cesare E, Splendiani A, Gallucci M (2015) MRI DWI/ADC signal predicts shrinkage of lumbar disc herniation after O2-O3 discolysis. Neuroradiol J 28(2):198–204. doi: 10.1177/1971400915576658 PubMedCrossRefGoogle Scholar
  5. 5.
    Splendiani A, Perri M, Conchiglia A, Fasano F, Di Egidio G, Masciocchi C, Gallucci M (2013) MR assessment of lumbar disk herniation treated with oxygen-ozone diskolysis: the role of DWI and related ADC versus intervertebral disk volumetric analysis for detecting treatment response. Neuroradiol J. 26(3):347–356PubMedCrossRefGoogle Scholar
  6. 6.
    Perri M, Grattacaso G, di Tunno V, Marsecano C, Gennarelli A, Michelini G, Splendiani A, Di Cesare E, Masciocchi C, Gallucci M (2015) T2 shine-through phenomena in diffusion-weighted MR imaging of lumbar discs after oxygen-ozone discolysis: a randomized, double-blind trial with steroid and O2-O3 discolysis versus steroid only. Radiol Med [Epub ahead of print]Google Scholar
  7. 7.
    Hoy D, Brooks P, Blyth F, Buchbinder R (2010) The epidemiology of low back pain. Best Pract Res Clin Rheumatol 24:769–781PubMedCrossRefGoogle Scholar
  8. 8.
    Claus A, Hides J, Moseley GL, Hodges P (2008) Sitting versus standing : does the intradiscal pressure cause disc degeneration or low back pain? J Electromyogr Kinesiol 18:550–558PubMedCrossRefGoogle Scholar
  9. 9.
    Parent EC, Videman T, Battiè MC (2006) The effect of lumbar flexion and extension on disc contour abnormality measured quantitatively on magnetic resonance imaging. Spine (Phila Pa 1976) 31:2836–2842CrossRefGoogle Scholar
  10. 10.
    Weishaupt D, Schmid MR, Zanetti M et al (2000) Positional MR imaging of the lumbar spine: does it demonstrate nerve root compromise not visible at conventional MR imaging? Radiology 215:247–253PubMedCrossRefGoogle Scholar
  11. 11.
    Vitzhum HE, Konig A, Seifert V (2000) Dynamic examination of the lumbar spine by using vertical, open magnetic resonance imaging. J Neurosurg 93:58–64Google Scholar
  12. 12.
    Manenti G, Liccardo G, Sergiacomi G, Ferrante L, D’Andrea G, Konda D, Fraioli B, Schillaci O, Simonetti G, Masala S (2003) Axial loading MRI of the lumbar spine. In vivo 17:413–420PubMedGoogle Scholar
  13. 13.
    Madsen R, Jensen TS, Pope M, Sorensen JS, Bendix T (2008) The effect of body position and axial load on spinal canal morphology : an MRI study of central spinal stenosi. Spine (Phila Pa 1976) 33:61–67CrossRefGoogle Scholar
  14. 14.
    Danielson B, Willer J (2001) Axially loaded magnetic resonance image of the lumbar spine in asyntomatic individuals. Spine (Phila Pa 1976) 26:2601–2606CrossRefGoogle Scholar
  15. 15.
    Shmid MR, Stucki G, Duewell S, Wildermuth S, Romanowsky B, Hodler J (1999) Changes in cross-sectional measurements of the spinal canal and intervertebral foramina as a function of body position: in vivo studies on an open- configuration MR system. Am J Roentgerol 172:1095–1102CrossRefGoogle Scholar
  16. 16.
    Gallucci M, Limbucci N, Paonessa A, Splendiani A (2007) Degenerative disease of the spine. Neuroimaging Clin N Am 17:87–103PubMedCrossRefGoogle Scholar
  17. 17.
    Splendiani A, Di Fabio MV, Barile A, Masciocchi C (2008) Tecnica di studio RM del rachide lombare sotto carico. In: Leone A, Martino F (eds) Imaging del rachide. Il vecchio e il nuovo. Springer, Rome, pp 123–124CrossRefGoogle Scholar
  18. 18.
    Fardon DF, Milette PC (2001) Nomenclature and classification of lumbar disc pathology. Recommendations of the combined task forces of the north american spine society, American society of spine radiology, and american society of neuroradiology. Spine 26:E93–E113PubMedCrossRefGoogle Scholar
  19. 19.
    Yoshida M, Shima K, Taniguchi Y, Tamaki T, Tanaka T (1992) Hypertrophied ligamentum flavum in lumbar spinal canal stenosis. Pathogenesis and morphologic and immunohistochemical observation. Spine (Phila Pa 1976) 17(11):1353–1360CrossRefGoogle Scholar
  20. 20.
    Jensen MC, Obuchowski N (1994) MRI of lumbar spine in people withouth back pain. N Engl J Med 331:69–73PubMedCrossRefGoogle Scholar
  21. 21.
    Leone A, Guglielmi G, Cassar-Pullicino VN, Bonomo L (2007) Lumbar intervertebral instability : a review. Radiology 245:62–77PubMedCrossRefGoogle Scholar
  22. 22.
    Adams MA, Hutton WC (1985) The effect of posture on the lumbar spine. J Bone Joint Surg Br 67(4):625–629PubMedGoogle Scholar
  23. 23.
    Landis RJ, Koch GG (1977) The measurement of observer agreement for categor- ical data. Biometrics. 33(159–74):15Google Scholar
  24. 24.
    Richelmi P, Valdenassi L, Berte F (2001) Basi farmacologiche dell’azione dell’ossigenoozono terapia. Riv Neuroradiol. 14(suppl 1):17–22CrossRefGoogle Scholar
  25. 25.
    McGregor AH, Anderton L, Gedroyc WM, Johnson J, Hughes SP (2002) The use of interventional open MRI to assess the kinematics of the lumbar spine in patients with spondylolisthesis. Spine 27:1582–1586PubMedCrossRefGoogle Scholar
  26. 26.
    Wildermuth S, Zanetti M, Duewell S et al (1998) Lumbar spine: quantitative and qualitative assessment of positional (upright flexion and extension) MR imaging and myelography. Radiology 207:391–398PubMedCrossRefGoogle Scholar
  27. 27.
    Splendiani A, Ferrari F, Barile A, Masciocchi C, Gallucci M (2014) Occult neural foraminal stenosis caused by association between disc degeneration and facet joint osteoarthritis: demonstration with dedicated upright MRI system. Radiol Med. 119(3):164–174. doi: 10.1007/s11547-013-0330-7 PubMedCrossRefGoogle Scholar
  28. 28.
    Schmid MR, Stucki G, Duewell S, Wildermuth S, Romanowski B, Hodler J (1999) Changes in cross-sectional measurements of the spinal canal and intervertebral foramina as a function of body position: in vivo studies on an open-configuration MR system. AJR Am J Roentgenol 172:1095–1102PubMedCrossRefGoogle Scholar
  29. 29.
    Hirasawa Y, Bashir WA, Smith FW, Magnusson ML, Pope MH, Takahashi K (2007) Postural changes of the dural sac in the lumbar spines of asymptomatic individuals using positional stand-up magnetic resonance imaging. Spine (Phila Pa 1976) 32:36–40CrossRefGoogle Scholar
  30. 30.
    Leone A, Guglielmi G, Cassar-Pullicino VN, Bonomo L (2007) Lumbar intervertebral instability: a review 1. Radiology 245(1):62–77PubMedCrossRefGoogle Scholar
  31. 31.
    Fujiwara A, Lim TH, An HS et al (2000) The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine 25:3036–3044PubMedCrossRefGoogle Scholar

Copyright information

© Italian Society of Medical Radiology 2015

Authors and Affiliations

  • Alessandra Splendiani
    • 1
  • Marco Perri
    • 2
    Email author
  • Giuseppe Grattacaso
    • 2
  • Valeria Di Tunno
    • 2
  • Claudia Marsecano
    • 2
  • Luca Panebianco
    • 2
  • Antonio Gennarelli
    • 2
  • Valentina Felli
    • 2
  • Marco Varrassi
    • 2
  • Antonio Barile
    • 2
  • Ernesto Di Cesare
    • 2
  • Carlo Masciocchi
    • 2
  • Massimo Gallucci
    • 1
  1. 1.Division of Neuroradiology, Department of Biotechnological and Applied Clinical Science, S Salvatore HospitalUniversity of L’AquilaL’AquilaItaly
  2. 2.Division of Radiology, Department of Biotechnological and Applied Clinical Science, S Salvatore HospitalUniversity of L’AquilaL’AquilaItaly

Personalised recommendations