Obtaining lumbar spine magnetic resonance imaging is burdensome: can we fix it?
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ABSTRACT:
SUBMITTER: Lambrechts MJ
PROVIDER: S-EPMC10331492 | biostudies-literature | 2023 Jun
REPOSITORIES: biostudies-literature
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Obtaining lumbar spine magnetic resonance imaging is burdensome: can we fix it?
Journal of spine surgery (Hong Kong) 20230509 2
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Project description: Not available
| S-EPMC11400652 | biostudies-literature
Project description:In vivo three-dimensional (3D) kinematics of the lumbar spine has not been well evaluated by the conventional methods because of their methodological limitations, while 3D intervertebral motions have been quantitatively determined by cadaver studies. We thus developed a novel 3D analyzing system for the relative motions of individual vertebrae using 3D magnetic resonance imaging (MRI) and analyzed in vivo 3D intervertebral motions of the lumbar spine during trunk rotation. Ten healthy volunteers underwent 3D MRI of the lumbar spine in nine positions with 15 degrees increments during trunk rotation (0 degrees , 15 degrees , 30 degrees , 45 degrees , and maximum). Relative motions of the lumbar spine were calculated by automatically superimposing a segmented 3D MRI of the vertebra in the neutral position over images of each position using the voxel-based registration method. These 3D motions were represented with 6 degrees of freedom by Euler angles and translations on the coordinate system. The mean axial rotation of ten healthy volunteers of each lumbar spinal segment in 45 degrees trunk rotation to each side ranged from 1.2 degrees to 1.7 degrees . Coupled flexion with axial rotation was observed at the segments from L1/2 to L5/S1. Coupled lateral bending of the segments from L1/2 to L4/5 was in the opposite direction of the trunk rotation, while that of T12/L1 and L5/S1 was in the same direction. The direction of the coupled lateral bending in the present study was different from that in the previous cadaver study only at L4/5. This difference might result from the non-load state of the supine position in the current study and/or the non-physiological state in the cadaver study. Our system has two limitations: (1) the study was conducted with each volunteer in the supine position, and (2) because the rotation device regulated trunk rotation, trunk rotation might not have been physiological. In vivo 3D intervertebral motions of the lumbar spine during trunk rotation were evaluated using our novel motion analysis system. These data may be useful for the optimal orthopaedic management of lumbar spinal disorders.
| S-EPMC2223353 | biostudies-literature
Project description:Development of a dual-tuned proton/sodium radiofrequency (RF) coil for magnetic resonance imaging (MRI) of the rabbit spine and quantification of sodium concentration in intervertebral discs.To develop the dual-tuned proton/sodium MRI of rabbit lumbar spine to investigate proteoglycan matrix content and intervertebral disc degeneration (IDD).IDD is a common chronic condition that may lead to back pain, limited activity, and disability. Early-stage IDD involves the loss of proteoglycan matrix and water content in the disc. Sodium MRI is a promising noninvasive technique for quantitative measurement of proteoglycan changes associated with IDD. The combined structural (proton) and biochemical (sodium) MRI facilitates the investigation of morphological and molecular changes associated with degeneration of discs.Multichannel dual-tuned proton/sodium transceiver RF coil of the rabbit spine was developed and optimized at 3T human scanner-8 channels allocated for the sodium coil and 4 channels for the proton coil. High-resolution anatomy proton images of the discs were acquired using turbo spin echo and dual echo steady state sequence. Sodium concentration of the discs was quantified from sodium magnetic resonance (MR) images that were calibrated for signal attenuation because of RF field inhomogeneity, sodium MR relaxation times, and disc thickness. Twelve rabbits (~1-yr old, female, 5.2 ± 0.4 kg) were used for measuring disc sodium concentration.High-resolution in vivo proton and sodium MR images of rabbit discs (?2-mm thickness) were successfully obtained using an in-house dual-tuned proton/sodium RF coil at 3T. The total acquisition time for each set of images was approximately 40 minutes. Sodium concentration of normal rabbit lumbar discs was measured at 269.7 ± 6.3 mM, and this measurement was highly reproducible, with 5.3% of coefficient of variation.Sodium concentrations of rabbit lumbar discs were reliably measured using our newly developed dual-tuned multichannel proton/sodium RF coil at 3T.
| S-EPMC3421064 | biostudies-literature
Project description:BackgroundThe acupotomy is an acupuncture device recently used to stimulate lumbar vertebrae such as transverse processes (TPs) and facet joints (FJs). However, there are many organs, nerves, and blood vessels, which can lead to side effects if the needle misses the treatment target. Therefore, information regarding appropriate insertion depths, which is currently lacking, could facilitate its safe use. We retrospectively investigated the depth from the skin to the TP and FJ of the lumbar vertebrae, using magnetic resonance imaging (MRI).MethodsThis retrospective chart review was conducted at a single medical centre in Korea. From 55,129 patient records, 158 subjects were selected. Perpendicular depth from the skin to the left and right TPs and FJs was measured using T1-weighted sagittal plane MRI. Depth differences between the left and right sides were evaluated using the paired t-test and analysis of covariance (body mass index [BMI] as a covariate). The influence of BMI on depth at each location was evaluated by simple linear regression analysis.ResultsThe mean age was 43.2 years and mean BMI was 23.6 kg/m2. The depth from skin to the TPs or FJs was unaffected by age, sex, or side. Mean depths (cm) were as follows: (TPs) L1 = 4.5, L2 = 4.9, L3 = 5.3, L4 = 5.7, L5 = 5.9; (FJs) L12 = 3.8, L23 = 4.0, L34 = 4.4, L45 = 4.6, L5S1 = 4.6. Depth was highly correlated with BMI at each location.ConclusionThe depth of TPs and FJs adjusted for BMI can safely and effectively be used for treatment via various invasive interventions, including acupotomy treatment, in the lumbar region.
| S-EPMC8054160 | biostudies-literature
Project description:BackgroundDetection of nerve involvement originating in the spine is a primary concern in the assessment of spine symptoms. Magnetic resonance imaging (MRI) has become the diagnostic method of choice for this detection. However, the agreement between MRI and other diagnostic methods for detecting nerve involvement has not been fully evaluated. The aim of this diagnostic study was to evaluate the agreement between nerve involvement visible in MRI and findings of nerve involvement detected in a structured physical examination and a simplified pain drawing.MethodsSixty-one consecutive patients referred for MRI of the lumbar spine were - without knowledge of MRI findings - assessed for nerve involvement with a simplified pain drawing and a structured physical examination. Agreement between findings was calculated as overall agreement, the p value for McNemar's exact test, specificity, sensitivity, and positive and negative predictive values.ResultsMRI-visible nerve involvement was significantly less common than, and showed weak agreement with, physical examination and pain drawing findings of nerve involvement in corresponding body segments. In spine segment L4-5, where most findings of nerve involvement were detected, the mean sensitivity of MRI-visible nerve involvement to a positive neurological test in the physical examination ranged from 16-37%. The mean specificity of MRI-visible nerve involvement in the same segment ranged from 61-77%. Positive and negative predictive values of MRI-visible nerve involvement in segment L4-5 ranged from 22-78% and 28-56% respectively.ConclusionIn patients with long-standing nerve root symptoms referred for lumbar MRI, MRI-visible nerve involvement significantly underestimates the presence of nerve involvement detected by a physical examination and a pain drawing. A structured physical examination and a simplified pain drawing may reveal that many patients with "MRI-invisible" lumbar symptoms need treatment aimed at nerve involvement. Factors other than present MRI-visible nerve involvement may be responsible for findings of nerve involvement in the physical examination and the pain drawing.
| S-EPMC2944219 | biostudies-literature
Project description:Study Design Retrospective case series. Objective To determine the rate of spinal incidental findings on magnetic resonance imaging (MRI) of the cervical, thoracic, and lumbar spine in the pediatric population. Methods We reviewed MRI imaging of the neuraxial spine in patients less than 18 years of age and documented abnormal spinal findings. We then reviewed the charts of these patients to determine the reason for ordering the study. Those who presented with pain were considered symptomatic. Those who had no presenting complaint were considered asymptomatic. The data were analyzed to break down the rate of spinal incidental findings in the cervical, thoracic, and lumbar spine, respectively. Results Thirty-one of the 99 MRIs had positive findings, with the most common being disk protrusion (51.6%). Spinal incidental findings were most common in the lumbar spine (9.4%) versus the cervical spine (8%) or thoracic spine (4.7%). In this group, Schmorl nodes and disk protrusion were the two most common findings (37.5% each). Other spinal incidental findings included a vertebral hemangioma and a Tarlov cyst. In the thoracic spine, the only spinal incidental finding was a central disk protrusion without spinal cord or nerve root compression. Conclusion MRI is a useful modality in the pediatric patient with scoliosis or complaints of pain, but the provider should remain cognizant of the potential for spinal incidental findings.
| S-EPMC4229374 | biostudies-other
Project description: Not available
| S-EPMC11572550 | biostudies-literature
Project description:Genome wide DNA methylation profiling of normal and tumour prostate samples. The Illumina Infinium MethylationEPIC Human DNA methylation oligonucleotide beads was used to obtain DNA methylation profiles across approximately 850,000 CpGs. Comparative assessment was carried out.
2018-12-01 | GSE101908 | GEO
Project description:PurposeTo characterize the inter- and intraobserver variability of qualitative, non-disk contour degenerative findings of the lumbar spine at magnetic resonance (MR) imaging.Materials and methodsThe case accrual method used to perform this institutional review board-approved, HIPAA-compliant retrospective study was the random selection of 111 interpretable MR examination cases of subjects from the Spine Patient Outcomes Research Trial. The subjects were aged 18-87 years (mean, 53 years +/- 16 [standard deviation]). Four independent readers rated the cases according to defined criteria. A subsample of 40 MR examination cases was selected for reevaluation at least 1 month later. The following findings were assessed: spondylolisthesis, disk degeneration, marrow endplate abnormality (Modic changes), posterior anular hyperintense zone (HIZ), and facet arthropathy. Inter- and intraobserver agreement in rating the data was summarized by using weighted kappa statistics.ResultsInterobserver agreement was good (kappa = 0.66) in rating disk degeneration and moderate in rating spondylolisthesis (kappa = 0.55), Modic changes (kappa = 0.59), facet arthropathy (kappa = 0.54), and posterior HIZ (kappa = 0.44). Interobserver agreement in rating the extent of Modic changes was moderate: kappa Values were 0.43 for determining superior anteroposterior extent, 0.47 for determining superior craniocaudal extent, 0.57 for determining inferior anteroposterior extent, and 0.48 for determining inferior craniocaudal extent. Intraobserver agreement was good in rating spondylolisthesis (kappa = 0.66), disk degeneration (kappa = 0.74), Modic changes (kappa = 0.64), facet arthropathy (kappa = 0.69), and posterior HIZ (kappa = 0.67). Intraobserver agreement in rating the extent of Modic changes was moderate, with kappa values of 0.54 for superior anteroposterior, 0.60 for inferior anteroposterior, 0.50 for superior craniocaudal, and 0.60 for inferior craniocaudal extent determinations.ConclusionThe interpretation of general lumbar spine MR characteristics has sufficient reliability to warrant the further evaluation of these features as potential prognostic indicators.
| S-EPMC2657480 | biostudies-literature
Project description:BackgroundAxial loading magnetic resonance imaging (MRI) of lumbar spine is of great significance in the diagnosis of lumbar diseases. However, the axial loading device used in clinic is unique and has some defects. Therefore, we aimed to investigate the effect and examinee comfort of a new device for axial loading lumbar MRI in asymptomatic volunteers.MethodsA new axial loading MRI device for the lumbar spine was developed. A total of 30 asymptomatic individuals underwent conventional lumbar MRI and axial loading lumbar MRI sequentially. The dural sac cross-sectional area (DSCA), sagittal vertebral canal diameter (SVCD), and disc height (DH) at L3-4, L4-5, and L5-S1 before and after axial loading were compared by two experienced radiologists. Examinee comfort during the two examinations was assessed.ResultsAll 30 volunteers completed the examinations with the new device. No difference in examinee comfort was found between conventional and axial loading MRI. After axial loading, the DSCA, SVCD, and DH showed the largest decreases at L4-5 followed by L5-S1 and L3-4, with the decreases in DSCA and SVCD at L4-5 being significant (P<0.05). Definite imaging-diagnosable disc herniation or bulging was shown at three intervertebral disc levels of three participants.ConclusionsThe new device could effectively implement axial loading of the lumbar spine without causing obvious discomfort for the examinee. The present study has demonstrated that significant changes occur in the lumbar spine of asymptomatic individuals after axial loading.
| S-EPMC9816728 | biostudies-literature