The Diagnosis And Treatment Value Of Axially Loaded Position MRI For Lumbar Degenerative Disease

Objective:To investigate the efficacy and advantage of axially loaded position MRI for the diagnosis and treatment of lumbar degenerative disease (LDD).Methods:To review 84 patients of lumbar degenerative disease in the Second Affiliated hospital of Chongqing Medical University from November 2013 to October 2014, and all the patients were examined by routine psoas relaxed position (RPRP) MRI and axially loaded position (ALP) MRI. Meanwhile, the size of the dural sac cross-sectional area (DSCA) was recorded. According to whether the symptom was replicable in extension position with axial loaded, all patients were divided into two groups (the negative and positive group). The difference of DSCA changes between these two groups was statistically analysed.Results:Compared with RPRP, there was a significant decrease (>15 mm2) of the DSCA during ALP in 49 patients (58.3%) and 76 disc levels (30.2%). Meanwhile, in no matter in L3/4、L4/5 or L5/S1, the difference of DSCA between these two postures was statistical significant (P<0.05). Of note, in L4/5 and L5/S1, the variation of DSC A of the negative and positive group during ALP was statistically different (P<0.05). However, in L3/4, there was no statistical difference(P>0.05).Conclusions:ALP could further improve the correlation between symptoms and MRI. And thus, it could also improve the positive rate, especially occult slippage and spinal canal stenosis. Meanwhile, for the patients with inconsistent clinical symptoms, physical signs and imaging examination, the diagnostic value was superior.