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01-01-2016 | MAGNETIC RESONANCE IMAGING

Magnetic resonance imaging (MRI) of the lumbar spine with dedicated G-scan machine in the upright position: a retrospective study and our experience in 10 years with 4305 patients

Authors: Alessandra Splendiani, Marco Perri, Giuseppe Grattacaso, Valeria Di Tunno, Claudia Marsecano, Luca Panebianco, Antonio Gennarelli, Valentina Felli, Marco Varrassi, Antonio Barile, Ernesto Di Cesare, Carlo Masciocchi, Massimo Gallucci

Published in: La radiologia medica | Issue 1/2016

Abstract

Purpose

To evaluate the pathological changes of the lumbar spine and the instability of the lumbar intervertebral joints observed in patients with low back pain, with the study of the transition from supine to orthostatic position through the use of dedicated MRI-G-scan machine.

Materials and Methods

Within 10 years, 4305 patients, aged between 21 and 80 years old, with history of low back pain with or without sciatica, underwent MRI examinations in upright and in supine position. The open MRI-scanner used is Esaote G-scan, which enables the acquisition of images in supine and standing positions. The used sequences were sagittal T2-weighted FSE, T1-weighted SE and axial 3D HYCE. Patients were divided into two groups: “negatives”, with no changes in the two positions (supine and upright), and “positives”, with MRI modifications of imaging in upright position.

Results

Orthostatic examination showed MRI changes in 2870 out of 4305 (66.6 %) patients, including 1252 males and 1618 females.

Conclusions

The G-scan is useful to assess instability of the lumbar spine detecting hidden modifications of protrusions and/or herniated discs already present in the supine position. It is also helpful in assessing the presence or modification of spondylolisthesis and lumbar canal stenosis.

Coste J, Paolaggi JB, Spira A (1991) Reliability of interpretation of plain lumbar spine radiographs in benign, mechanical low-back pain. Spine 16:426–428PubMedCrossRef

Kelsey JL, Hochberg MC (1988) Epidemiology of chronic musculoskeletal disorders. Annu Rev Public Health 9:379–401PubMedCrossRef

Modic MT, Pavlicek W, Weinstein MA et al (1984) Magnetic resonance imaging of intervertebral disk disease. Clinical and pulse sequence considerations. Radiology 152:103–111PubMedCrossRef

Perri M, Grattacaso G, Di Tunno V, Marsecano C, Di Cesare E, Splendiani A, Gallucci M (2015) MRI DWI/ADC signal predicts shrinkage of lumbar disc herniation after O₂-O₃ discolysis. Neuroradiol J 28(2):198–204. doi:10.1177/1971400915576658 PubMedCrossRef

Splendiani A, Perri M, Conchiglia A, Fasano F, Di Egidio G, Masciocchi C, Gallucci M (2013) MR assessment of lumbar disk herniation treated with oxygen-ozone diskolysis: the role of DWI and related ADC versus intervertebral disk volumetric analysis for detecting treatment response. Neuroradiol J. 26(3):347–356PubMedCrossRef

Perri M, Grattacaso G, di Tunno V, Marsecano C, Gennarelli A, Michelini G, Splendiani A, Di Cesare E, Masciocchi C, Gallucci M (2015) T2 shine-through phenomena in diffusion-weighted MR imaging of lumbar discs after oxygen-ozone discolysis: a randomized, double-blind trial with steroid and O₂-O₃ discolysis versus steroid only. Radiol Med [Epub ahead of print]

Hoy D, Brooks P, Blyth F, Buchbinder R (2010) The epidemiology of low back pain. Best Pract Res Clin Rheumatol 24:769–781PubMedCrossRef

Claus A, Hides J, Moseley GL, Hodges P (2008) Sitting versus standing : does the intradiscal pressure cause disc degeneration or low back pain? J Electromyogr Kinesiol 18:550–558PubMedCrossRef

Parent EC, Videman T, Battiè MC (2006) The effect of lumbar flexion and extension on disc contour abnormality measured quantitatively on magnetic resonance imaging. Spine (Phila Pa 1976) 31:2836–2842CrossRef

10.

Weishaupt D, Schmid MR, Zanetti M et al (2000) Positional MR imaging of the lumbar spine: does it demonstrate nerve root compromise not visible at conventional MR imaging? Radiology 215:247–253PubMedCrossRef

11.

Vitzhum HE, Konig A, Seifert V (2000) Dynamic examination of the lumbar spine by using vertical, open magnetic resonance imaging. J Neurosurg 93:58–64

12.

Manenti G, Liccardo G, Sergiacomi G, Ferrante L, D’Andrea G, Konda D, Fraioli B, Schillaci O, Simonetti G, Masala S (2003) Axial loading MRI of the lumbar spine. In vivo 17:413–420PubMed

13.

Madsen R, Jensen TS, Pope M, Sorensen JS, Bendix T (2008) The effect of body position and axial load on spinal canal morphology : an MRI study of central spinal stenosi. Spine (Phila Pa 1976) 33:61–67CrossRef

14.

Danielson B, Willer J (2001) Axially loaded magnetic resonance image of the lumbar spine in asyntomatic individuals. Spine (Phila Pa 1976) 26:2601–2606CrossRef

15.

Shmid MR, Stucki G, Duewell S, Wildermuth S, Romanowsky B, Hodler J (1999) Changes in cross-sectional measurements of the spinal canal and intervertebral foramina as a function of body position: in vivo studies on an open- configuration MR system. Am J Roentgerol 172:1095–1102CrossRef

16.

Gallucci M, Limbucci N, Paonessa A, Splendiani A (2007) Degenerative disease of the spine. Neuroimaging Clin N Am 17:87–103PubMedCrossRef

17.

Splendiani A, Di Fabio MV, Barile A, Masciocchi C (2008) Tecnica di studio RM del rachide lombare sotto carico. In: Leone A, Martino F (eds) Imaging del rachide. Il vecchio e il nuovo. Springer, Rome, pp 123–124CrossRef

18.

Fardon DF, Milette PC (2001) Nomenclature and classification of lumbar disc pathology. Recommendations of the combined task forces of the north american spine society, American society of spine radiology, and american society of neuroradiology. Spine 26:E93–E113PubMedCrossRef

19.

Yoshida M, Shima K, Taniguchi Y, Tamaki T, Tanaka T (1992) Hypertrophied ligamentum flavum in lumbar spinal canal stenosis. Pathogenesis and morphologic and immunohistochemical observation. Spine (Phila Pa 1976) 17(11):1353–1360CrossRef

20.

Jensen MC, Obuchowski N (1994) MRI of lumbar spine in people withouth back pain. N Engl J Med 331:69–73PubMedCrossRef

21.

Leone A, Guglielmi G, Cassar-Pullicino VN, Bonomo L (2007) Lumbar intervertebral instability : a review. Radiology 245:62–77PubMedCrossRef

22.

Adams MA, Hutton WC (1985) The effect of posture on the lumbar spine. J Bone Joint Surg Br 67(4):625–629PubMed

23.

Landis RJ, Koch GG (1977) The measurement of observer agreement for categor- ical data. Biometrics. 33(159–74):15

24.

Richelmi P, Valdenassi L, Berte F (2001) Basi farmacologiche dell’azione dell’ossigenoozono terapia. Riv Neuroradiol. 14(suppl 1):17–22CrossRef

25.

McGregor AH, Anderton L, Gedroyc WM, Johnson J, Hughes SP (2002) The use of interventional open MRI to assess the kinematics of the lumbar spine in patients with spondylolisthesis. Spine 27:1582–1586PubMedCrossRef

26.

Wildermuth S, Zanetti M, Duewell S et al (1998) Lumbar spine: quantitative and qualitative assessment of positional (upright flexion and extension) MR imaging and myelography. Radiology 207:391–398PubMedCrossRef

27.

Splendiani A, Ferrari F, Barile A, Masciocchi C, Gallucci M (2014) Occult neural foraminal stenosis caused by association between disc degeneration and facet joint osteoarthritis: demonstration with dedicated upright MRI system. Radiol Med. 119(3):164–174. doi:10.1007/s11547-013-0330-7 PubMedCrossRef

28.

Schmid MR, Stucki G, Duewell S, Wildermuth S, Romanowski B, Hodler J (1999) Changes in cross-sectional measurements of the spinal canal and intervertebral foramina as a function of body position: in vivo studies on an open-configuration MR system. AJR Am J Roentgenol 172:1095–1102PubMedCrossRef

29.

Hirasawa Y, Bashir WA, Smith FW, Magnusson ML, Pope MH, Takahashi K (2007) Postural changes of the dural sac in the lumbar spines of asymptomatic individuals using positional stand-up magnetic resonance imaging. Spine (Phila Pa 1976) 32:36–40CrossRef

30.

Leone A, Guglielmi G, Cassar-Pullicino VN, Bonomo L (2007) Lumbar intervertebral instability: a review 1. Radiology 245(1):62–77PubMedCrossRef

31.

Fujiwara A, Lim TH, An HS et al (2000) The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine 25:3036–3044PubMedCrossRef

Title: Magnetic resonance imaging (MRI) of the lumbar spine with dedicated G-scan machine in the upright position: a retrospective study and our experience in 10 years with 4305 patients
Authors: Alessandra Splendiani
Marco Perri
Giuseppe Grattacaso
Valeria Di Tunno
Claudia Marsecano
Luca Panebianco
Antonio Gennarelli
Valentina Felli
Marco Varrassi
Antonio Barile
Ernesto Di Cesare
Carlo Masciocchi
Massimo Gallucci
Publication date: 01-01-2016
Publisher: Springer Milan
Published in: La radiologia medica / Issue 1/2016
Print ISSN: 0033-8362
Electronic ISSN: 1826-6983
DOI: https://doi.org/10.1007/s11547-015-0570-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Magnetic resonance imaging (MRI) of the lumbar spine with dedicated G-scan machine in the upright position: a retrospective study and our experience in 10 years with 4305 patients

Abstract

Purpose

Materials and Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Materials and Methods

Results

Conclusions

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