SOCIETY OF SKELETAL RADIOLOGY (EESR) 2004 - ABSTRACTS ORAL
June 18-19, 2004 Augsburg, Germany
POTENTIAL VALUE OF MR IMAGING IN THE SEATED POSITION: A STUDY
OF 116 PATIENTS SUFFERING FROM LOW BACK PAIN AND SCIATICA.
T. Muthukumar1, F.W.
Smith2, D. Wardlaw2, M. Pope2. 1Robert Jones & Agnes Hunt
Orthopaedic Hospital, Oswestry, UK, 2University of Aberdeen.
The clinical symptoms of the lumbar spinal stenosis
are often posture related. The availability of Open “Stand-Up”
MRI enables images of the spine to be made in any posture.
This study explores the potential of upright MRI scanning
in neutral, flexion and extension in sitting and supine position
of patients with low back symptoms.
& METHOD: 116 patients
[45 female & 71 male] (Age 35 – 71 years,
mean 44 years), suffering from low
back pain and/or sciatica were studied. Each examination
was performed using a 0.6 Tesla Open “Stand-Up”
MRI. (FONAR, Melville, NY) MR Images were obtained in both
the supine, seated neutral, seated flexed and extended positions.
Measurements from “Normal discs” show changes
of only 1mm in disc height between supine and sitting, increasing
to 2 – 4mm reduction in height anteriorly in forward
flexion and between 2 – 4mm reduction in height posteriorly
on extension Measurements from “Degenerate discs”
show 1 - 3mm change in disc height between supine and sitting
and significant reduction in disc height and position on flexion
and extension. 108 prolapsed discs showed reduction of posterior
prolapse on forward flexion & increase in extension, whilst
23 showed a decrease in posterior prolapse on extension. In
21 cases, the presence of a Grade
1 spondylolisthesis, not evident in the supine examination,
was demonstrated in the seated position. In
all cases, a degree of instability was demonstrated in the
flexion and extension views.
In 4 cases of sciatica experienced whilst seated, in which
the supine examination showed no abnormality, transforaminal
disc herniation was demonstrated in the seated position.
CONCLUSION: We believe that the
ability to image in the seated position is a major advance
in the examination of the lumbar spine, especially in those
patients with spondylolisthesis and position dependent disc