Department of Radiology, Federal University of Rio de Janeiro School of Medicine, Rio de Janeiro, Brazil.
Eur J Radiol. 2012 Apr;81(4):e561-4. doi: 10.1016/j.ejrad.2011.06.027. Epub 2011 Jul 8.
To evaluate the imaging findings of patients with clinical symptoms of lower back pain who underwent magnetic resonance imaging (MRI) of the lumbar spine with axial loading.
We examined 120 patients by MRI, before and after axial loading, using a compression device that applied 50% of their body weight for a load time of 5min. The dural sac cross area (DSCA) was examined by two experienced radiologists before and after axial load, and their findings were compared. Degenerative abnormalities within and adjacent to the spinal canal were also analyzed.
A reduction in DSCA greater than 15mm(2) after axial load was defined as significant, and was found in 81 patients (67.5%) and 138 disc spaces (38.3%). Reduction was most frequent at L4-L5 (n=55). For other disorders, a 9% increase in cases of bulging disc was seen during axial loading, and seven disc spaces showed protrusion/extrusion only after load. Facet joint synovial cysts, foraminal stenosis, and hypertrophy of the flavum ligaments showed almost no differences, pre- and post-load.
For adequate evaluation of lumbar symptoms, examination should be performed with axial loading, especially in cases of suspected spinal stenosis.
评估有下腰痛临床症状并接受腰椎轴向加载磁共振成像（MRI）检查的患者的影像学表现。
我们使用一种压缩装置对 120 例患者进行了 MRI 检查，在施加 50%体重的负荷持续 5 分钟前后进行。由两名有经验的放射科医生在轴向负荷前后检查硬脊膜囊横截面积（DSCA），并比较他们的检查结果。还分析了椎管内和相邻部位的退行性异常。
轴向负荷后 DSCA 减少大于 15mm(2)定义为显著，在 81 例患者（67.5%）和 138 个椎间盘空间（38.3%）中发现。L4-L5 最常见（n=55）。对于其他病变，轴向加载时椎间盘膨出的病例增加了 9%，负荷后仅 7 个椎间盘空间显示突出/脱出。在加载前后，小关节滑膜囊肿、椎间孔狭窄和黄韧带肥厚几乎没有差异。
为了充分评估腰椎症状，应进行轴向加载检查，特别是在怀疑有椎管狭窄的情况下。
