Lumbar Stenosis Rates in Symptomatic Patients Using Weight-Bearing and Recumbent Magnetic Resonance Imaging

• Published in: Journal of manipulative and physiological therapeutics 2011-10, Vol.34 (8), p.557-561
• Main Authors: Gilbert, John W., MD, Martin, J. Chad, DC, DO, Wheeler, Greg R., MD, Storey, Benjamin B., MD, Mick, Gregory E., DO, Richardson, Gay B., MD, Herder, Stephanie L., MD, Gyarteng-Dakwa, Kwadwo, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Disability Evaluation; Female; Humans; Lumbar Vertebrae; Lumbar Vertebrae - pathology; Magnetic Resonance Imaging; Magnetic Resonance Imaging - methods; Male; Middle Aged; Pain Measurement; Physical Medicine and Rehabilitation; Posture; Retrospective Studies; Severity of Illness Index; Spinal Canal; Spinal Diseases; Spinal Stenosis; Spinal Stenosis - diagnosis; Spinal Stenosis - pathology; Treatment Outcome; Weight-Bearing
• ISSN: 0161-4754; 1532-6586
• DOI: 10.1016/j.jmpt.2011.08.002

Abstract Objective The purpose of this study was to determine the rate of lumbar stenosis detected via magnetic resonance imaging (MRI) in patients with symptomatic foraminal stenosis, lateral recess stenosis, or central stenosis. Methods A retrospective review was performed on 1983 MRI scans from a 2-year period on 1486 symptomatic patients. Of these patients, 761 were scanned in the recumbent position using low-field (0.3 T, Airis II; Hitachi, Twinsburg, Ohio) MRI, and 725 were scanned in an upright sitting position using midfield (0.6 T) open Upright MRI (Fonar Corp, Melville, NY). In total, 986 serial scans (recumbent) and 997 serial scans (weight-bearing) were performed. Results Of scans performed in the recumbent position, stenoses were identified in 382 scans (38.8%), central stenosis in 119 scans (12%), lateral recess stenosis in 91 scans (9.2%), and foraminal stenosis in 327 scans (33.2%). Of scans performed in a weight-bearing position, stenoses were identified in 565 scans (56.7%), central stenosis in 136 scans (13.6%), lateral recess stenosis in 206 scans (20.7%), and foraminal stenosis in 524 scans (52.6%). Conclusions The stenosis rates as indicated by MRI interpretation ranged between 38.5% (recumbent) and 56.7% (weight-bearing). These rates are higher than those reported in the medical literature for asymptomatic patients. Further study is needed to determine whether weight-bearing, compared with recumbent, MRI better informs the clinician in the diagnosis of spinal stenosis.