Conventional Supine MRI With a Lumbar Pillow—An Alternative to Weight-bearing MRI for Diagnosing Spinal Stenosis?

Hansen, Bjarke Brandt; Hansen, Philip; Grindsted, Jacob; Rasti, Zoreh; Bliddal, Henning; Riis, R.; Boesen, Mikael

doi:10.1097/brs.0000000000001889

Cited by 14 publications

(15 citation statements)

References 27 publications

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“…Lumbar extension seems to aggravate spinal canal stenosis related to degenerative changes. 38 A similar affect may be achieved by scanning in the supine position with a pillow behind the lumbar spine with 21,49 or without axial loading. 38 Whether WBMRI provides added information over scanning in the supine extended position is not clear.…”

Section: Weight-bearing Mri Of the Lumbar Spinementioning

confidence: 99%

“…30,36,37 Also, many of the degenerative pathologies seen on supine MRI imaging are more evident in the upright position. 36,38 WBMRI seems to exaggerate, to a varying degree, most degenerative spinal pathologies such as segmental instability (olisthesis, scoliosis) 36 and disk degenerative morphology (disk height, 37,39-41 disk bulging, protrusion, extrusion, 30,40,[42][43][44] high-intensity zone tears, 45 spinal stenosis, 36,38,45 and ligamentum flavum bulging 46 ) (►Figs. 3 and 4).…”

Section: Weight-bearing Mri Of the Lumbar Spinementioning

confidence: 99%

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Weight-bearing MRI of the Lumbar Spine: Technical Aspects

Nordberg

Hansen

Nybing

et al. 2019

Semin Musculoskelet Radiol

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Magnetic resonance imaging (MRI) has an established role in the assessment of degenerative musculoskeletal conditions. However, conventional supine MRI findings often correlate poorly with clinical findings. Some patients experience accentuated back pain in the weight-bearing position. Therefore, supine MRI may underestimate the severity of degenerative spine findings. To try and improve the clinical validity of spine imaging, axial loading devices have been used with conventional supine MR imaging to simulate loading of the upright spine. More recently, upright weight-bearing MRI systems (0.25–0.6 T) were introduced, allowing images to be obtained in the standing or seated weight-bearing position and even during upright flexion or extension, rotation, or bending. Some scanners even enable capturing of real-time spinal movement. This review addresses the technical aspects and potential challenges of weight-bearing MRI, both in clinical practice and research.

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Section: Weight-bearing Mri Of the Lumbar Spinementioning

confidence: 99%

Section: Weight-bearing Mri Of the Lumbar Spinementioning

confidence: 99%

Weight-bearing MRI of the Lumbar Spine: Technical Aspects

Nordberg

Hansen

Nybing

et al. 2019

Semin Musculoskelet Radiol

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“…In contrast, studies indicated that standing weight-bearing MRI and supine MRI with a lumbar pillow hyperextending the lumbar spine may result in similar morphological changes in the ligamentum flavum with reduction in spinal canal dimensions. 8,9 However, examining patients with a lumbar pillow can be painful. 8 These findings suggest that lumbar extension is an important dynamic contributor to symptomatology in spinal stenosis.…”

Section: Changes In the Ligamentum Flavummentioning

confidence: 99%

“…8,9 However, examining patients with a lumbar pillow can be painful. 8 These findings suggest that lumbar extension is an important dynamic contributor to symptomatology in spinal stenosis.…”

Section: Changes In the Ligamentum Flavummentioning

confidence: 99%

Weight-bearing MRI of the Lumbar Spine: Spinal Stenosis and Spondylolisthesis

Hansen

Nordberg

Hansen

et al. 2019

Semin Musculoskelet Radiol

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Symptoms of degenerative lumbar spinal stenosis include back pain, radiculopathy, claudication, and muscular fatigue that tend to be predominant in the standing position or during walking. Lumbar spondylolisthesis is also a well-known cause of spinal stenosis, lateral recess, and neural foraminal narrowing that tends to become more severe in the upright position. This indicates a functional positional component of both spinal stenosis and spondylolisthesis. Lumbar spinal stenosis and spondylolisthesis are typically evaluated by magnetic resonance imaging (MRI) performed in the supine position with a pillow under the patient's lower limbs that slightly flexes the lumbar spine and ameliorates symptoms. Because these two entities tend to be aggravated in the upright position, it seems rational to also consider performing diagnostic imaging in these patients in the upright position. This article reviews the use of weight-bearing MRI for lumbar spinal stenosis and spondylolisthesis.

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“…Weight bearing MRI (WB-MRI) scanners of various designs have recently become available. Using a i.e., a tilting low-field magnet of 0.25 T, supine and upright WB-MRI of the knee, spine and foot can be performed with potential added diagnostic value in selected pathologies 37,38 . Supine imaging of the spine in the WB-MRI system has also shown to have equal diagnostic potential in degenerative spine disease compared to high-field MRI examinations 39 .…”

Section: Diagnosismentioning

confidence: 99%