The Imaging of Lumbar Spinal Stenosis

A Comprehensive Study of Patients With Surgically Treated Lumbar Spinal Stenosis With Neurogenic Claudication

“…The transverse images of the lumbar spine were obtained with magnetic resonance imaging in thirty-eight patients and with computed tomography myelography in the remaining twenty-four [17][18][19] . The cross-sectional area of the dural tube was measured at the midpoint of each intervertebral level with stenosis; it was also measured at the level of the pars interarticularis in the patients who had isthmic spondylolisthesis.…”

Effect of Intervertebral Disk Degeneration on Spinal Stenosis During Magnetic Resonance Imaging With Axial Loading

“…3) Many authors have used the DCSA as a standard diagnostic method to estimate central canal stenosis. 4,6,8,19,26) Comparison of measurements of the anteroposterior diameter of the bony canal by computed tomography, the anteroposterior diameter of the dural sac by myelography, and the cross-sectional area of the dural sac by computed tomography with surgical findings in 24 patients with a clinical diagnosis of central canal stenosis revealed that DCSA measurement was the most accurate and effective method to diagnose central canal stenosis. 3) Disk degeneration is associated with reduced hydration capacity of the nucleus pulposus with more fibrotic appearance and less effective resistance to compressive forces in the spine, 15,18) leading to decreased disk height and less taut annulus fibrosus, with consequent diffuse disk bulging and inward buckling of the ligamentum flavum.…”

“…3) Disk degeneration is associated with reduced hydration capacity of the nucleus pulposus with more fibrotic appearance and less effective resistance to compressive forces in the spine, 15,18) leading to decreased disk height and less taut annulus fibrosus, with consequent diffuse disk bulging and inward buckling of the ligamentum flavum. 19,27) In vitro studies have shown that degenerated disks have less water content and reduced volume of the nucleus pulposus, resulting in decreased intradiscal pressure and increased compressibility of the nucleus. 1) In addition, the laxity of the anterior and posterior longitudinal ligaments allows greater tensile deformation of the disk in a degenerated disk.…”

“…2,23,24) This dynamic phenomenon suggests that imaging techniques should be performed in the erect, extended position. 19) Magnetic resonance (MR) imaging of the spine is usually performed in a psoas-relaxed position, that is with the patient in the most comfortable supine position, with hips and knees flexed. Clearly, MR imaging in this position may not represent the state of the spinal canal during walking or standing, when the patient usually experiences symptoms, so carries considerable risk of underestimating or even missing stenosis of the spinal canal.…”

Diagnostic Values of Magnetic Resonance Imaging in the Diagnosis of Lumbar Foraminal Stenosis Compared with Surgical Findings

“…Lumbar Spinal Stenosis (LSS) usually presents in the fifth or sixth decade [1]. The patients classically present with back pain, unilateral or bilateral neurogenic claudication, weakness, numbness/tingling and radicular pain [2].…”