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Effects of spine loading in a patient with post-decompression lumbar disc herniation: observations using an open weight-bearing MRI

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Abstract

Purpose

Our objective was to use an open weight-bearing MRI to identify the effects of different loading conditions on the inter-vertebral anatomy of the lumbar spine in a post-discectomy recurrent lumbar disc herniation patient.

Methods

A 43-year-old male with a left-sided L5-S1 post-decompression re-herniation underwent MR imaging in three spine-loading conditions: (1) supine, (2) weight-bearing on standing (WB), and (3) WB with 10 % of body mass axial loading (WB + AL) (5 % through each shoulder). A segmentation-based proprietary software was used to calculate and compare linear dimensions, angles and cross sections across the lumbar spine.

Results

The L5 vertebrae showed a 4.6 mm posterior shift at L5-S1 in the supine position that changed to an anterior translation >2.0 mm on WB. The spinal canal sagittal thickness at L5-S1 reduced from supine to WB and WB + AL (13.4, 10.6, 9.5 mm) with corresponding increases of 2.4 and 3.5 mm in the L5-S1 disc protrusion with WB and WB + AL, respectively. Change from supine to WB and WB + AL altered the L5-S1 disc heights (10.2, 8.6, 7.0 mm), left L5-S1 foramen heights (12.9, 11.8, 10.9 mm), L5-S1 segmental angles (10.3°, 2.8°, 4.3°), sacral angles (38.5°, 38.3°, 40.3°), L1–L3–L5 angles (161.4°, 157.1°, 155.1°), and the dural sac cross sectional areas (149, 130, 131 mm2). Notably, the adjacent L4–L5 segment demonstrated a retro-listhesis >2.3 mm on WB.

Conclusion

We observed that with weight-bearing, measurements indicative of spinal canal narrowing could be detected. These findings suggest that further research is warranted to determine the potential utility of weight-bearing MRI in clinical decision-making.

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Authors and Affiliations

  1. Ohio Musculoskeletal and Neurological Institute (OMNI), Ohio University, Athens, OH, USA

    Niladri Kumar Mahato, Daryl Sybert, Tim Law & Brian Clark

  2. Department of Biomedical Sciences, Ohio University, Athens, OH, USA

    Niladri Kumar Mahato & Brian Clark

  3. Division of Orthopedic Surgery, OrthoNeuro, New Albany, OH, USA

    Daryl Sybert

  4. Department of Family Medicine, Ohio University, Athens, OH, USA

    Tim Law

  5. Clinical and Translational Research Unit, Ohio University, Athens, OH, USA

    Tim Law

  6. Department of Geriatric Medicine, Ohio University, Athens, OH, USA

    Tim Law & Brian Clark

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  1. Niladri Kumar Mahato
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  2. Daryl Sybert
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Correspondence to Niladri Kumar Mahato.

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Mahato, N.K., Sybert, D., Law, T. et al. Effects of spine loading in a patient with post-decompression lumbar disc herniation: observations using an open weight-bearing MRI. Eur Spine J 26 (Suppl 1), 17–23 (2017). https://doi.org/10.1007/s00586-016-4581-6

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  • DOI: https://doi.org/10.1007/s00586-016-4581-6

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