Lorenc Tomasz, Glinkowski Wojciech Michał, Gołębiowski Marek
1st Department of Clinical Radiology, Medical University of Warsaw, 02-004 Warsaw, Poland.
Department of Medical Informatics and Telemedicine, Center of Excellence "TeleOrto" for Telediagnostics and Treatment of Disorders and Injuries of the Locomotor System, Medical University of Warsaw, 00-581 Warsaw, Poland.
J Clin Med. 2021 Aug 29;10(17):3884. doi: 10.3390/jcm10173884.
This retrospective observational study was conducted to identify factors associated with low back-related leg pain (LBLP) using axially loaded magnetic resonance imaging (AL-MRI). Ninety patients with low back pain (LBP) underwent AL-MRI of the lumbar spine. A visual analog scale and patient pain drawings were used to evaluate pain intensity and location and determine LBLP cases. The values of AL-MRI findings were analyzed using a logistic regression model with a binary dependent variable equal to one for low back-related leg pain and zero otherwise. Logistic regression results suggested that intervertebral joint effusion (odds ratio (OR) = 4.58; = 0.035), atypical ligamenta flava (OR = 5.77; = 0.003), and edema of the lumbar intervertebral joint (OR = 6.41; = 0.003) were more likely to be present in LBLP patients. Advanced disc degeneration ( = 0.009) and synovial cysts ( = 0.004) were less frequently observed in LBLP cases. According to the AL-MRI examinations, the odds of having LBLP are more likely if facet effusion, abnormal ligamenta flava, and lumbar facet joint edema are present on imaging than if not. The assessment of lumbar spine morphology in axial loaded MRI adds value to the potential understanding of LBLP, but further longitudinal and loaded-unloaded comparative studies are required to determine the role of acute dynamic changes and instability in LBLP development.
本回顾性观察性研究旨在利用轴向负荷磁共振成像(AL-MRI)确定与下腰部相关腿痛(LBLP)相关的因素。90例腰痛(LBP)患者接受了腰椎的AL-MRI检查。使用视觉模拟量表和患者疼痛图来评估疼痛强度和位置,并确定LBLP病例。使用逻辑回归模型分析AL-MRI检查结果的值,二元因变量在存在下腰部相关腿痛时等于1,否则等于0。逻辑回归结果表明,椎间关节积液(优势比(OR)=4.58;P=0.035)、非典型黄韧带(OR=5.77;P=0.003)和腰椎椎间关节水肿(OR=6.41;P=0.003)在LBLP患者中更可能出现。在LBLP病例中,椎间盘退变晚期(P=0.009)和滑膜囊肿(P=0.004)的观察频率较低。根据AL-MRI检查,与未出现相比,影像学上出现小关节积液、黄韧带异常和腰椎小关节水肿时发生LBLP的几率更高。轴向负荷MRI对腰椎形态的评估有助于对LBLP的潜在理解,但需要进一步的纵向和负荷-非负荷对比研究来确定急性动态变化和不稳定在LBLP发生中的作用。