Utilizzo dell'Axial Loader nello studio della colonna lobosacrale

Abstract

English

Lo scopo dello studio è di valutare le modificazioni indotte dall'applicazione di carico assiale durante I'esame RM della colonna lombosacrale. Sono stati sottoposti all'indagine 75 pazienti consecutivi con varie patologie degenerative del rachide lombosacrale, anche già trattati chirurgicamente. I risultati hanno dimostrato varie modificazioni dopo applicazione del carico, in particolare la osservazione più frequente è stata l'aumento della stenosi. In un caso l'esame ottenuto dopo applicazione di carico ha modificato radicalmente il trattamento ponendo indicazione all'intervento chirurgico. Dalle osservazioni preliminari riteniamo che le modificazioni indotte dal carico assiale siano interessanti da valutare con RM; sarà comunque indispensabile uno studio su una popolazione omogenea per diagnosi clinica per verificarne la effettiva utilità.

Keywords

lumbar spine functional study MR

Get full access to this article

View all access options for this article.

References

Bram

Zanetti

: MR abnormalities of the intervertebral disks and ajacent bone marrow as predictors of segmental instability of the lumbar spine. Acta Radiol 39(1) 18: 23, 1988.

Broberg

: On the mechanical behavior of intervertebral discs. Spine 8: 151–165, 1983.

Cartolari

: Functional evaluation of the lumbar spine with axial loaded computed tomography (AL-CT) and Cine AL-CT. Rivista di Neuroradiologia 10: 569–584, 1997.

Cinotti

Postacchini

: Predisposing factors in degenerative spondylolisthesis. A radiographic and CT study. Int Orthop 21(5): 337–342, 1997.

Dai

: The effect of flexion - extension motion of the lumbar spine on the capacity of the spinal canal. An experimental study. Spine 14(5): 523–525, 1998.

Danielson

Willen

: Axial loading of the spine during CT and MR in patients with suspected lumbar spinal stenosis. Acta Radiol 39: 604–611, 1998.

Friberg

: Lumbar instability: a dynamic approach by traction-compression radiography. Spine 12: 119–129, 1987.

Haughton

Lim

: Intervertebral disk appearance correlated with stiffness of lumbar spinal motion segments. Am J Neuroradiol 20: 1161–1165, 1999.

Hayes

Howard

: Roentgenographic evaluation of lumbar spine flexion-extension in asyntomatic individuals. Spine 14: 327–330, 1989.

10.

Mailleux

Ghosez

: Distension of the inter-facet joints in MRI: and indirect sign of an existing understimation of spondylolisthesis and canal stenosis. J Belge Radiol 81(6): 283: 5, 1998.

11.

Nowicki

Haughton

: Occult lumbar lateral spinal stenosis in neural foramina subjected to physiologic loading. Am J Neuroradiol 17(9): 1605–1614, 1996.

12.

Olerud

Sjostrom

: Spontaneous effect of increased stability of the lower spine in case of severe chronic back pain- the answer of an external transpeduncolar fixation test. Clin Orthop 203: 67–74, 1986.

13.

Olsson

Selvik

Willner

: Mobility in the lumbosacral spine after fusion studied with the aid of roentgen stereophotogrammetry. Clin Orthop 129: 181–190, 1977.

14.

Pitkanen

Manninen

: Limited usefulness of traction-compression films in the radiographic diagnosis of lumbar spinal instability. Comparison with flexion-extension films. Spine 22(2): 193–197, 1997.

15.

Schmidt

: The stiffness of lumbar spinal motion segments with a “high intensity zone” in the anulus fibrosus. Spine 23: 2167–2173, 1998.

16.

Wildermuth

Zanetti

: Lumbar spine: quantitative and qualitative assessment of positional (upright flexion and extension) MR imaging and myelography. Radiology 207:391–398, 1998.

17.

Willen

Danielson

: Dynamic effects on the lumbar spinal canal. Axially loaded CT-myelography and MRI in Patients with sciatica and/or neurogenic claudication. Spine 22(24): 2968–2976, 1997.

18.

Haughton

: Anulus fibrosus in bulging intervertebral disks. Radiology 169(3): 761–763, 1988.