الفهرس | Only 14 pages are availabe for public view |
Abstract D egenerative disease of the lumbar spine is the most common cause of lower back pain and disability in adults. The diagnosis of degenerative disease of the lumbar spine is based on a combination of clinical signs and symptoms and conventional MRI. Despite being the imaging modality of choice for evaluating lumbar disc abnormalities, conventional MRI offers limited information for accurate disease diagnosis and proper management decision. The apparent disconnect between conventional MRI findings and clinical manifestation stems from the dynamic nature of the lumbar spine and the effect of the position on the biomechanics of the spine and subsequently on revealing the hidden pathologies explaining the clinical symptoms of the patient. Recent reports suggest that positional MRI may serve as a useful tool for evaluating positional related changes in the spine alignment, neural compression and spinal canal stenosis. In our study, patients with clinical presentation of lumbar spine degenerative disease attending to the radiology department had positional MRI added to their conventional MRI scans and we evaluated the role of dynamic MRI and its added value in improving the clinical outcome of the patients. We conclude from this study that, functional imaging tools; like dynamic MRI of the lumbar spine, allows better visualization of hidden pathologies in conventional MRI especially with patients with clinical/radiological mismatch therefore it gives the spine surgeon a helpful tool in order to understand and explain patients’ symptomatology. It also provides documented proof of neural compression and hence facilitates accurate preoperative planning regarding the procedure and the target level, and accordingly better postoperative outcome. |