Axial Loading during MR Imaging Can Influence Treatment Decision for Symptomatic Spinal Stenosis
Previous studies have shown that axial loading can narrow the spinal canal. However, the clinical significance is unclear. The purpose of this study was to determine whether the narrowing of the spinal canal with axial loading during MR imaging could influence treatment decision for spinal stenosis....
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| Veröffentlicht in: | American journal of neuroradiology : AJNR 2004-02, Vol.25 (2), p.170-174 |
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| creator | Hiwatashi, Akio Danielson, Barbro Moritani, Toshio Bakos, Robert S Rodenhause, Thomas G Pilcher, Webster H Westesson, Per-Lennart |
| description | Previous studies have shown that axial loading can narrow the spinal canal. However, the clinical significance is unclear. The purpose of this study was to determine whether the narrowing of the spinal canal with axial loading during MR imaging could influence treatment decision for spinal stenosis.
Two hundred patients with clinical symptoms of spinal stenosis underwent routine MR imaging and then immediately underwent axially loaded MR imaging. We selected 20 of these patients because they had narrowing of the spinal canal shown on the axially loaded images. Three experienced neurosurgeons evaluated these 20 patients based on clinical information and routine MR images. The same neurosurgeons were then asked for second treatment decisions based on the same clinical information but with axially loaded MR images.
Axial loading during MR imaging of the lumbar spine can influence neurosurgeons in their treatment decisions for symptomatic spinal stenosis. For this selected group of patients, all three neurosurgeons changed their treatment decision from conservative management to decompressive surgery for five patients when shown the axially loaded MR images. For two other patients, two neurosurgeons changed their treatment decisions, and for three additional patients, one neurosurgeon changed his treatment decision, all based on the axially loaded MR images. Treatment was not changed from surgical to medical management for any of the patients when shown the axially loaded images.
In selected patients with spinal stenosis and apparent narrowing of the spinal canal shown by axially loaded MR imaging, the additional information gained from this technique can influence experienced neurosurgeons in their treatment decisions. |
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Two hundred patients with clinical symptoms of spinal stenosis underwent routine MR imaging and then immediately underwent axially loaded MR imaging. We selected 20 of these patients because they had narrowing of the spinal canal shown on the axially loaded images. Three experienced neurosurgeons evaluated these 20 patients based on clinical information and routine MR images. The same neurosurgeons were then asked for second treatment decisions based on the same clinical information but with axially loaded MR images.
Axial loading during MR imaging of the lumbar spine can influence neurosurgeons in their treatment decisions for symptomatic spinal stenosis. For this selected group of patients, all three neurosurgeons changed their treatment decision from conservative management to decompressive surgery for five patients when shown the axially loaded MR images. For two other patients, two neurosurgeons changed their treatment decisions, and for three additional patients, one neurosurgeon changed his treatment decision, all based on the axially loaded MR images. Treatment was not changed from surgical to medical management for any of the patients when shown the axially loaded images.
In selected patients with spinal stenosis and apparent narrowing of the spinal canal shown by axially loaded MR imaging, the additional information gained from this technique can influence experienced neurosurgeons in their treatment decisions.</description><identifier>ISSN: 0195-6108</identifier><identifier>EISSN: 1936-959X</identifier><identifier>PMID: 14970014</identifier><identifier>CODEN: AAJNDL</identifier><language>eng</language><publisher>Oak Brook, IL: Am Soc Neuroradiology</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Decompression, Surgical ; Equipment Design ; Female ; Humans ; Image Enhancement - instrumentation ; Investigative techniques, diagnostic techniques (general aspects) ; Leg - innervation ; Lumbar Vertebrae - pathology ; Lumbar Vertebrae - physiopathology ; Lumbar Vertebrae - surgery ; Magnetic Resonance Imaging - instrumentation ; Male ; Medical sciences ; Middle Aged ; Nervous system ; Neurologic Examination ; Posture - physiology ; Radiculopathy - diagnosis ; Radiculopathy - physiopathology ; Radiculopathy - surgery ; Radiodiagnosis. Nmr imagery. Nmr spectrometry ; Spinal Stenosis - diagnosis ; Spinal Stenosis - physiopathology ; Spinal Stenosis - surgery ; Spine ; Weight-Bearing - physiology</subject><ispartof>American journal of neuroradiology : AJNR, 2004-02, Vol.25 (2), p.170-174</ispartof><rights>2004 INIST-CNRS</rights><rights>Copyright © American Society of Neuroradiology 2004</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7974596/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7974596/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,53769,53771</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15489046$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14970014$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hiwatashi, Akio</creatorcontrib><creatorcontrib>Danielson, Barbro</creatorcontrib><creatorcontrib>Moritani, Toshio</creatorcontrib><creatorcontrib>Bakos, Robert S</creatorcontrib><creatorcontrib>Rodenhause, Thomas G</creatorcontrib><creatorcontrib>Pilcher, Webster H</creatorcontrib><creatorcontrib>Westesson, Per-Lennart</creatorcontrib><title>Axial Loading during MR Imaging Can Influence Treatment Decision for Symptomatic Spinal Stenosis</title><title>American journal of neuroradiology : AJNR</title><addtitle>AJNR Am J Neuroradiol</addtitle><description>Previous studies have shown that axial loading can narrow the spinal canal. However, the clinical significance is unclear. The purpose of this study was to determine whether the narrowing of the spinal canal with axial loading during MR imaging could influence treatment decision for spinal stenosis.
Two hundred patients with clinical symptoms of spinal stenosis underwent routine MR imaging and then immediately underwent axially loaded MR imaging. We selected 20 of these patients because they had narrowing of the spinal canal shown on the axially loaded images. Three experienced neurosurgeons evaluated these 20 patients based on clinical information and routine MR images. The same neurosurgeons were then asked for second treatment decisions based on the same clinical information but with axially loaded MR images.
Axial loading during MR imaging of the lumbar spine can influence neurosurgeons in their treatment decisions for symptomatic spinal stenosis. For this selected group of patients, all three neurosurgeons changed their treatment decision from conservative management to decompressive surgery for five patients when shown the axially loaded MR images. For two other patients, two neurosurgeons changed their treatment decisions, and for three additional patients, one neurosurgeon changed his treatment decision, all based on the axially loaded MR images. Treatment was not changed from surgical to medical management for any of the patients when shown the axially loaded images.
In selected patients with spinal stenosis and apparent narrowing of the spinal canal shown by axially loaded MR imaging, the additional information gained from this technique can influence experienced neurosurgeons in their treatment decisions.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Decompression, Surgical</subject><subject>Equipment Design</subject><subject>Female</subject><subject>Humans</subject><subject>Image Enhancement - instrumentation</subject><subject>Investigative techniques, diagnostic techniques (general aspects)</subject><subject>Leg - innervation</subject><subject>Lumbar Vertebrae - pathology</subject><subject>Lumbar Vertebrae - physiopathology</subject><subject>Lumbar Vertebrae - surgery</subject><subject>Magnetic Resonance Imaging - instrumentation</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nervous system</subject><subject>Neurologic Examination</subject><subject>Posture - physiology</subject><subject>Radiculopathy - diagnosis</subject><subject>Radiculopathy - physiopathology</subject><subject>Radiculopathy - surgery</subject><subject>Radiodiagnosis. Nmr imagery. Nmr spectrometry</subject><subject>Spinal Stenosis - diagnosis</subject><subject>Spinal Stenosis - physiopathology</subject><subject>Spinal Stenosis - surgery</subject><subject>Spine</subject><subject>Weight-Bearing - physiology</subject><issn>0195-6108</issn><issn>1936-959X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2004</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkE1rGzEQhpeS0LhJ_0LRpbktSFp9XgrBSVqDSyBOIDd1LGttFa3kSrtx_e-7IU6TnGZgHp53eD9UE6IbUWuuH46qCSaa14JgdVJ9KuU3xphrST9WJ4RpiTFhk-rXxV8PAc0TrHxco9WQn8bPWzTrYP20TiGiWWzD4KJ16C476DsXe3TprC8-RdSmjBb7btunDnpv0WLr42hc9C6m4stZddxCKO7zYZ5W99dXd9Mf9fzm-2x6Ma83DaV9zbWVSlDFGqsAg6TYSYItFyBbxoSTS0ob3bROrTglgi5BKGEp09QtW8V0c1p9e_Zuh2XnVnb8MUMw2-w7yHuTwJv3l-g3Zp0ejdSScS1GwflBkNOfwZXedL5YFwJEl4ZiFCZiZPkIfnmb9D_ipdQR-HoAoFgIbYY4dvXKcaY0ZuKV2_j1ZuezM6WDEEYtMbvdjnJDDZG4-QdRKo8G</recordid><startdate>20040201</startdate><enddate>20040201</enddate><creator>Hiwatashi, Akio</creator><creator>Danielson, Barbro</creator><creator>Moritani, Toshio</creator><creator>Bakos, Robert S</creator><creator>Rodenhause, Thomas G</creator><creator>Pilcher, Webster H</creator><creator>Westesson, Per-Lennart</creator><general>Am Soc Neuroradiology</general><general>American Society of Neuroradiology</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20040201</creationdate><title>Axial Loading during MR Imaging Can Influence Treatment Decision for Symptomatic Spinal Stenosis</title><author>Hiwatashi, Akio ; Danielson, Barbro ; Moritani, Toshio ; Bakos, Robert S ; Rodenhause, Thomas G ; Pilcher, Webster H ; Westesson, Per-Lennart</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-h322t-59c7862843c8a0a720e710c56a7f446e7b22393fe8d52162ba686c2492ebf8493</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2004</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Decompression, Surgical</topic><topic>Equipment Design</topic><topic>Female</topic><topic>Humans</topic><topic>Image Enhancement - instrumentation</topic><topic>Investigative techniques, diagnostic techniques (general aspects)</topic><topic>Leg - innervation</topic><topic>Lumbar Vertebrae - pathology</topic><topic>Lumbar Vertebrae - physiopathology</topic><topic>Lumbar Vertebrae - surgery</topic><topic>Magnetic Resonance Imaging - instrumentation</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nervous system</topic><topic>Neurologic Examination</topic><topic>Posture - physiology</topic><topic>Radiculopathy - diagnosis</topic><topic>Radiculopathy - physiopathology</topic><topic>Radiculopathy - surgery</topic><topic>Radiodiagnosis. Nmr imagery. Nmr spectrometry</topic><topic>Spinal Stenosis - diagnosis</topic><topic>Spinal Stenosis - physiopathology</topic><topic>Spinal Stenosis - surgery</topic><topic>Spine</topic><topic>Weight-Bearing - physiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hiwatashi, Akio</creatorcontrib><creatorcontrib>Danielson, Barbro</creatorcontrib><creatorcontrib>Moritani, Toshio</creatorcontrib><creatorcontrib>Bakos, Robert S</creatorcontrib><creatorcontrib>Rodenhause, Thomas G</creatorcontrib><creatorcontrib>Pilcher, Webster H</creatorcontrib><creatorcontrib>Westesson, Per-Lennart</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of neuroradiology : AJNR</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hiwatashi, Akio</au><au>Danielson, Barbro</au><au>Moritani, Toshio</au><au>Bakos, Robert S</au><au>Rodenhause, Thomas G</au><au>Pilcher, Webster H</au><au>Westesson, Per-Lennart</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Axial Loading during MR Imaging Can Influence Treatment Decision for Symptomatic Spinal Stenosis</atitle><jtitle>American journal of neuroradiology : AJNR</jtitle><addtitle>AJNR Am J Neuroradiol</addtitle><date>2004-02-01</date><risdate>2004</risdate><volume>25</volume><issue>2</issue><spage>170</spage><epage>174</epage><pages>170-174</pages><issn>0195-6108</issn><eissn>1936-959X</eissn><coden>AAJNDL</coden><abstract>Previous studies have shown that axial loading can narrow the spinal canal. However, the clinical significance is unclear. The purpose of this study was to determine whether the narrowing of the spinal canal with axial loading during MR imaging could influence treatment decision for spinal stenosis.
Two hundred patients with clinical symptoms of spinal stenosis underwent routine MR imaging and then immediately underwent axially loaded MR imaging. We selected 20 of these patients because they had narrowing of the spinal canal shown on the axially loaded images. Three experienced neurosurgeons evaluated these 20 patients based on clinical information and routine MR images. The same neurosurgeons were then asked for second treatment decisions based on the same clinical information but with axially loaded MR images.
Axial loading during MR imaging of the lumbar spine can influence neurosurgeons in their treatment decisions for symptomatic spinal stenosis. For this selected group of patients, all three neurosurgeons changed their treatment decision from conservative management to decompressive surgery for five patients when shown the axially loaded MR images. For two other patients, two neurosurgeons changed their treatment decisions, and for three additional patients, one neurosurgeon changed his treatment decision, all based on the axially loaded MR images. Treatment was not changed from surgical to medical management for any of the patients when shown the axially loaded images.
In selected patients with spinal stenosis and apparent narrowing of the spinal canal shown by axially loaded MR imaging, the additional information gained from this technique can influence experienced neurosurgeons in their treatment decisions.</abstract><cop>Oak Brook, IL</cop><pub>Am Soc Neuroradiology</pub><pmid>14970014</pmid><tpages>5</tpages></addata></record> |
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| source | MEDLINE; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adult Aged Biological and medical sciences Decompression, Surgical Equipment Design Female Humans Image Enhancement - instrumentation Investigative techniques, diagnostic techniques (general aspects) Leg - innervation Lumbar Vertebrae - pathology Lumbar Vertebrae - physiopathology Lumbar Vertebrae - surgery Magnetic Resonance Imaging - instrumentation Male Medical sciences Middle Aged Nervous system Neurologic Examination Posture - physiology Radiculopathy - diagnosis Radiculopathy - physiopathology Radiculopathy - surgery Radiodiagnosis. Nmr imagery. Nmr spectrometry Spinal Stenosis - diagnosis Spinal Stenosis - physiopathology Spinal Stenosis - surgery Spine Weight-Bearing - physiology |
| title | Axial Loading during MR Imaging Can Influence Treatment Decision for Symptomatic Spinal Stenosis |
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