Department of Radiology, University of L'Aquila, 67100, L'Aquila, Italy,
Radiol Med. 2014 Mar;119(3):164-74. doi: 10.1007/s11547-013-0330-7. Epub 2013 Dec 12.
The aim of our study was to evaluate the presence of dynamic foraminal stenosis using a new low-field dedicated magnetic resonance (MR) unit with a balancing system that allows images to be acquired both in the recumbent and upright position. Imaging of lumbar spine with the patient in a supine, nonweight-bearing position is likely to misrepresent the degree and potential risk of spinal stenosis.
In the period between September 2008 and May 2011, we selected 630 symptomatic patients aged 40-65 years (mean age 56) who underwent conventional MR in clinostatic position. The study only included selected patients (total 160) who underwent clinostatic and orthostatic evaluation using a dedicated MR system (G-scan). The biomechanical parameters were also considered. Changes in the dimension of the neural foramina were compared using the presence of disc and facet degeneration by statistical analysis.
Stenosis of the intervertebral foramen was never found in the presence of normal intervertebral discs either in the presence or in the absence of facet disease, in either clinostatic or orthostatic position. Sixty-one stenotic levels were detected which were visualised exclusively in scans obtained under weight-bearing conditions. We named this dynamic condition "occult stenosis". In all of these cases, disc disease was associated with facet pathology.
Our data show that the association between disc pathology and facet osteoarthrosis can cause occult foraminal stenosis. Strategies to image the spine under physiological load conditions may improve the clinical diagnosis of radicular pain.
我们研究的目的是使用一种新的带有平衡系统的低场专用磁共振（MR）设备来评估动态椎间孔狭窄的存在，该平衡系统允许在仰卧和直立两种体位下采集图像。让患者处于仰卧、非承重体位下进行腰椎成像可能会错误地反映脊柱狭窄的程度和潜在风险。
在 2008 年 9 月至 2011 年 5 月期间，我们选择了 630 名 40-65 岁（平均年龄 56 岁）有症状的患者进行常规仰卧位 clinostatic 磁共振成像。本研究仅包括 160 名经专门的磁共振系统（G-scan）进行 clinostatic 和直立评估的选定患者。还考虑了生物力学参数。通过统计分析比较了椎间盘和小关节退变存在时神经孔尺寸的变化。
在存在或不存在小关节疾病的情况下，正常椎间盘始终不存在椎间孔狭窄，无论是在 clinostatic 还是在直立位置。在承重条件下采集的扫描中仅发现了 61 个狭窄水平。我们将这种动态情况命名为“隐匿性狭窄”。在所有这些情况下，椎间盘疾病都与小关节病理相关。
我们的数据表明，椎间盘病变与小关节骨关节炎之间的关联可能导致隐匿性椎间孔狭窄。在生理负荷条件下进行脊柱成像的策略可能会改善神经根性疼痛的临床诊断。
