Lumbar Stenosis Rates in Symptomatic Patients Using Weight-Bearing and Recumbent Magnetic Resonance Imaging

Gilbert, Jane; Martin, J. Chad; Wheeler, Greg R.; Storey, Benjamin; Mick, Gregory E.; Richardson, Gay B.; Herder, Stephanie L.; Gyarteng-Dakwa, Kwadwo

doi:10.1016/j.jmpt.2011.08.002

Cited by 10 publications

(14 citation statements)

References 24 publications

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“…With the upright position, disc pathologies or foraminal stenosis may become more salient, revealing potential nerve root compression not visible on supine images. [ 13 14 15 16 ] To date, upright imaging has been used to provide primarily qualitative assessments of foraminal stenosis in symptomatic patients. [ 4 11 13 16 ] Limited quantitative data are available for foramen dimensions in asymptomatic patients.…”

Section: Introductionmentioning

confidence: 99%

“…[ 13 14 15 16 ] To date, upright imaging has been used to provide primarily qualitative assessments of foraminal stenosis in symptomatic patients. [ 4 11 13 16 ] Limited quantitative data are available for foramen dimensions in asymptomatic patients. [ 15 ] The literature is scarce regarding the quantitative assessment of the intervertebral foramen in upright imaging as a comparison between symptomatic patients and asymptomatic patients.…”

Section: Introductionmentioning

confidence: 99%

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Upright magnetic resonance imaging of the lumbar spine: Back pain and radiculopathy

Nguyen

Doan

Shabani

et al. 2016

J Craniovert Jun Spine

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Background:Lumbar back pain and radiculopathy are common diagnoses. Unfortunately, conventional magnetic resonance imaging (MRI) findings and clinical symptoms do not necessarily correlate in the lumbar spine. With upright imaging, disc pathologies or foraminal stenosis may become more salient, leading to improvements in diagnosis.Materials and Methods:Seventeen adults (10 asymptomatic and 7 symptomatic volunteers) provided their informed consent and participated in the study. A 0.6T upright MRI scan was performed on each adult in the seated position. Parameters were obtained from the L2/3 level to the L5/S1 level including those pertaining to the foramen [cross-sectional area (CSA), height, mid-disc width, width, thickness of ligamentum flavum], disc (bulge, height, width), vertebral body (height and width), and alignment (lordosis angle, wedge angle, lumbosacral angle). Each parameter was compared based on the spinal level and volunteer group using two-factor analysis of variance (ANOVA). Bonferroni post hoc analysis was used to assess the differences between individual spinal levels.Results:Mid-disc width accounted for 56% of maximum foramen width in symptomatic volunteers and over 63% in asymptomatic volunteers. Disc bulge was 48% greater in symptomatic volunteers compared to asymptomatic volunteers. CSA was generally smaller in symptomatic volunteers compared to asymptomatic volunteers, particularly at the L4-L5 and L5-S1 spinal levels. Thickness of ligamentum flavum (TLF) generally increased from the cranial to caudal spinal levels where the L4-L5 and L5-S1 spinal levels were significantly thicker than the L1-L2 spinal level.Conclusions:The data implied that upright MRI could be a useful diagnostic option, as it can delineate pertinent differences between symptomatic volunteers and asymptomatic volunteers, especially with respect to foraminal geometry.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Upright magnetic resonance imaging of the lumbar spine: Back pain and radiculopathy

Nguyen

Doan

Shabani

et al. 2016

J Craniovert Jun Spine

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“…Neurogenic claudication, back and leg pain, comorbidities, and other nociceptive pain indexes are well studied in patients with LSS (16)(17)(18)(19). It has also been reported that patients with LSS have less intense leg pain than those with lumbar disc herniation and that their symptoms are more often increased by lumbar extension and relieved by bending forward or sitting (2,17,20).…”

Section: Resultsmentioning

confidence: 99%

“…Lumbar spinal stenosis (LSS) is one of the most common conditions, which causes pain and disabilities in older people (1). This condition is commonly associated with lumbar degenerative disc disease and spondylosis so-called acquired lumbar stenosis (2). It results in the narrowing of the spinal canal, lateral nerve roots, and intervertebral neural foramina at one or more levels.…”

Section: Introductionmentioning

confidence: 99%

Neuropathic Pain and Disability in Patients with Lumbar Spinal Stenosis

Ağırman¹,

Akgün²

2018

tjgeri

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In this study, we aimed to determine the characteristics of neuropathic pain and clarify the relationships between the clinical signs, symptom characteristics and disability in patients with lumbar spinal stenosis. Materials and Method: Seventy-nine patients diagnosed with clinical and radiological lumbar spinal stenosis were included in the study. Pain severity was assessed using a selfadministered visual analog scale (0-10 cm). Subjective disability was measured using the Oswestry Disability Index and Istanbul Low Back Pain Disability Index. To identify neuropathic pain, the physician-administered Douleur Neuropathique 4 questionnaire was utilized. Results: A total of 79 patients (35 males, 44 females) with a mean age of 56.88±12.13 (range, 35-89) years were included in the study. The average symptom duration was 24.5 months. The Douleur Neuropathique 4 score was ≥4 in 41 patients (51.8%), indicating that they had neuropathic pain. A significant correlation was observed between the Douleur Neuropathique 4 score and age (R=0.350, p=0.002), body mass index (R=0.239, p=0.034), and visual analog scale (R=0.453, p< 0.001). Conclusion: Approximately half of all patients with lumbar spinal stenosis in our cohort had neuropathic pain. Higher age, body mass index and increased pain scores demonstrate important relationships with neuropathic pain.

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“…7,[13][14][15] As a result, medical imaging is typically limited to static assessments, and therefore many functional cervical disorders cannot be assessed through these techniques. 10,[16][17][18] Instead, diagnoses of cervical dysfunctions are regularly accomplished using specific manual An Official Journal of ISB www.JAB-Journal.com ORIGINAL RESEARCH medicine (palpatory) analyses. 19,20 Of particular interest to this research are the evaluations of cervical spine dysfunctions made by clinicians using passive diagnostic motions-the use of external (clinician induced) forces to move specific body parts through a range of motion (ROM) for diagnostic purposes.…”

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confidence: 99%

Differences in Human Cervical Spine Kinematics for Active and Passive Motions of Symptomatic and Asymptomatic Subject Groups

Rutledge

Bush

Vorro

et al. 2013

Journal of Applied Biomechanics

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Most musculoskeletal disorders of the head and neck regions cannot be identified through imaging techniques; therefore clinician-conducted assessments (passive motions) are used to evaluate the functional ability of these regions. Although active motions do not require interaction with a clinician, these movements can also provide diagnostic indicators of dysfunction. The purpose of this research was to determine whether kinematic measures differed between active and passive movements of participants in symptomatic and asymptomatic groups. Data obtained on cervical lateral flexion range of motion (ROM), coupled axial rotation, and the angular velocity of lateral flexion were statistically analyzed and demonstrated differences between active and passive motions for symptomatic and asymptomatic subjects. Active motions had higher angular velocities (P < .001) and larger ROMs, with greater lateral flexions (P < .05). The asymptomatic group produced a larger average lateral flexion of 7.9° at an average angular velocity of 2 deg/s greater than the symptomatic group. Trends with regard to group assignment were the same for active and passive motions. This work demonstrates the potential for using kinematic measures of active and passive motions to develop an objective standard for diagnoses of cervical dysfunction and supports validity of the clinician-based analysis to distinguish between participant groups.

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Lumbar Stenosis Rates in Symptomatic Patients Using Weight-Bearing and Recumbent Magnetic Resonance Imaging

Cited by 10 publications

References 24 publications

Upright magnetic resonance imaging of the lumbar spine: Back pain and radiculopathy

Upright magnetic resonance imaging of the lumbar spine: Back pain and radiculopathy

Neuropathic Pain and Disability in Patients with Lumbar Spinal Stenosis

Differences in Human Cervical Spine Kinematics for Active and Passive Motions of Symptomatic and Asymptomatic Subject Groups

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