J Korean Soc Spine Surg.  2012 Dec;19(4):152-157. 10.4184/jkss.2012.19.4.152.

Effect of Axial loading on Lumbar spine MRI: Comparative Study of Effect between a Patient Group with Claudication and a Patient Group without Claudication

• Lee JY
• Lee JG
• Oh BS
• Lee HB
• Koo BJ

• KMID: 2209550
• DOI: http://doi.org/10.4184/jkss.2012.19.4.152

Abstract

STUDY DESIGN: This study intended to find out differences of effects by axial loading in MRI examination in a patient group with neurologic claudication and a group without neurologic claudication.
OBJECTIVES
It was intended to understand in which group the effects of axial loading can be expected when taking MRI on the lumbar spine. SUMMARY OF THE LITERATURE REVIEW: The study of Willen and Danielson found spinal canal stenosis, which cannot be found by existing methods comparing an MRI taken in bended posture of lumbar without axial loading implementation by MRI taken with axial loading implementation. Hiwatashi et al. also reported that there was a change of treatment direction by laminectomy after axial loading in patients who were intended to take a conservational treatment before the axial loading.
MATERIALS AND METHODS
A total of 39 patients and 54 intervertebral discs were compared. The distances from a sagittal plane before and after intervertebral discs were compared by measuring a sectional area of dura mater in a horizontal plane image and two groups were compared by existence of patients' neurologic claudication.
RESULTS
The AP diameter before and after a intervertebral discs increased into 41.98 mm from 41.1 mm on the average and the sectional area of dura mater showed 137.47mm2 before loading and 119.86mm2 after loading on the average. There was not a significant difference in the distances before and after axial loading implementation, but a significant difference was found in the sectional area of dura mater.
CONCLUSION
Axial loading would contribute to diagnose spinal disease, and especially, spinal canal stenosis in a patient group with claudication.

Keyword

Lumbar MRI; Axial loading MRI; Spinal stenosis; Claudication

MeSH Terms

Constriction, Pathologic
Dura Mater
Humans
Intervertebral Disc
Laminectomy
Posture
Spinal Canal
Spinal Diseases
Spinal Stenosis
Spine

Figure

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  Fig. 1. Dynawell L-spine compression device.

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  Fig. 2. Preloading and postloading sagittal view of 51years old male patient, it shows increase of AP diameter after axial loading.

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  Fig. 3. Preloading and postloading axial view of 51 years old male patient, it shows sectional area of dura mater decrease after axial loading.

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