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Axial Loading During Lumbar Spine MR Imaging Can Influence Treatment Decision
for Spinal Stenosis
Barbro Danielson MD, PhD
Göteborg, Sweden
Akio Hiwatashi MD, Toshio Moritani, MD, P-L Westesson MD, PhD, DDS
Rochester NY, USA
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PAIN and NEUROLOGICAL SYMPTOMS are often accentuated when WALKING and STANDING
Patients are often symptom free in supine position This device simulates the upright patient position
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Axial loading during Lumbar Spine MR imaging accentuates spinal stenosis
Neurogenic claudication, sciatica
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Purpose Evaluate if this information
influences treatment decision
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Patients 20 (6 female, 14 male)
Diagnosis neurogenic claudication, LBP, and/or sciatica,
Mean age 54 yrs (32–75 yrs)
MR scanner 1 Tesla Siemens Sequences Axial T2 without loading
Axial T2 with axial loading
Material and Methods
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MRI OF THE LUMBAR SPINE
in supine
without and with axial loading
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Two neurosurgeons
reviewed images
with clinical history
treatment decision?
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Treatment decision was changed due to decrease in dural cross sectional area
No load Axial load
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Treatment decision was changed due to worsening lateral recess stenosis
No load Axial load
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Treatment decision was changed due to increase in size of synovial cyst
No load Axial load
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Treatment decision
changed from
conservative to operative
6 /20 patients - 30 %
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Axial loading during MRI of the lumbar spine
• increases the sensitivity for spinal stenosis
• influences the treatment decision
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