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Comparative Study
. 2019 Apr;92(1096):20180851.
doi: 10.1259/bjr.20180851. Epub 2019 Jan 17.

Disc and nerve root findings on lumbar MRI with straightened v s flexed hips and knees-pilot study

Ansgar Espeland  1   2 , Nina Dalen  3
Affiliations
Comparative Study

Disc and nerve root findings on lumbar MRI with straightened v s flexed hips and knees-pilot study

Ansgar Espeland et al. Br J Radiol. 2019 Apr.

Abstract

Objective:: To compare disc and nerve root findings, image quality, and pain between supine lumbar MRI positions with straightened v s flexed hips and knees.

Methods:: In this prospective pilot study, 14 adults with sciatica or suspected lumbar radiculopathy underwent MRI supine with their hips and knees flexed and then straightened. For each position, two experienced radiologists assessed disc contour, location/size of disc herniation, nerve root affection, image quality, image evaluation difficulty, and sagittal angles between the vertebral bodies at each disc level L3-S1. Patients scored pain (0-10) after MRI in each position. We compared MRI assessments and mean pain scores (t-test, log-transformation) between the two positions.

Results:: We found no clear difference in disc bulges, disc herniation, nerve root affection, image quality, or image evaluation difficulty between MRI with straightened v s flexed knees/hips. Herniation size differed ≤ 0.6 mm between the two positions. Sagittal angles between neighboring vertebral bodies differed ≤3.8°. Mean pain score after MRI with straightened v s flexed knees/hips was 4.64 v s 3.29 (p = 0.005).

Conclusion:: In this pilot study, supine lumbar MRI with straightened vs flexed hips/knees showed similar disc and nerve root findings. The straightened position appeared more painful.

Advances in knowledge:: In previous studies, spondylolisthesis increased on supine MRI with straightened v s flexed lower limbs, but corresponding data on disc findings were lacking. In this pilot study, supine lumbar MRI with straightened rather than flexed hips and knees was more painful and did not improve the diagnosis of disc or nerve root findings.

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Figures

Figure 1.
Figure 1.
Supine lumbar MRI position with flexed hips and knees and a standard foam wedge beneath the knees.
Figure 2.
Figure 2.
MRI findings in Patient No 2. A disc herniation at L3/L4 (arrows) in contact with the right L4 nerve root is unchanged between supine positions with flexed (a, b) and straightened (c, d) hips and knees. The figure also illustrates angles measured at each disc level between the posterior borders of the upper and lower vertebrae (a) and between the upper and lower endplates (c).
See this image and copyright information in PMC

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References

    1. Lao LF , Zhong GB , Li QY , Liu ZD , Lao LF . Kinetic magnetic resonance imaging analysis of spinal degeneration: a systematic review . Orthop Surg 2014. ; 6 : 294 – 9 . doi: 10.1111/os.12137 - DOI - PMC - PubMed
    1. Zamani AA , Moriarty T , Hsu L , Winalski CS , Schaffer JL , Isbister H , et al. . Functional MRI of the lumbar spine in erect position in a superconducting open-configuration Mr system: preliminary results . J Magn Reson Imaging 1998. ; 8 : 1329 – 33 . doi: 10.1002/jmri.1880080622 - DOI - PubMed
    1. Tarantino U , Fanucci E , Iundusi R , Celi M , Altobelli S , Gasbarra E , et al. . Lumbar spine MRI in upright position for diagnosing acute and chronic low back pain: statistical analysis of morphological changes . J Orthopaed Traumatol 2013. ; 14 : 15 – 22 . doi: 10.1007/s10195-012-0213-z - DOI - PMC - PubMed
    1. Weishaupt D , Schmid MR , Zanetti M , Boos N , Romanowski B , Kissling RO , et al. . Positional MR imaging of the lumbar spine: does it demonstrate nerve root compromise not visible at conventional MR imaging? Radiol 2000. ; 215 : 247 – 53 . doi: 10.1148/radiology.215.1.r00ap06247 - DOI - PubMed
    1. Zou J , Yang H , Miyazaki M , Wei F , Hong SW , Yoon SH , et al. . Missed lumbar disc herniations diagnosed with kinetic magnetic resonance imaging . Spine 2008. ; 33 : E140 – E144 . doi: 10.1097/BRS.0b013e3181657f7e - DOI - PubMed

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