Comparing Spinopelvic Angles and Magnification on Supine MRI With Standing Radiographs in Lumbar Spinal Stenosis.

IF 1.6 4区医学 Q3 CLINICAL NEUROLOGY

Clinical Spine Surgery Pub Date : 2025-04-29 DOI:10.1097/BSD.0000000000001814

Aryan Banitalebi, Ivar Rossvoll, Hasan Banitalebi, Tor Åge Myklebust, Erland Hermansen

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引用次数: 0

Abstract

Study design: Radiologic cross-sectional study based on a prospective cohort study (level III).

Objective: Investigate whether lumbar lordosis (LL) and sacral slope (SS) differ significantly on supine magnetic resonance imaging (MRI) versus standing radiographs in nondeformity lumbar spinal stenosis (LSS). Secondly, to quantify the amount of magnification on standing lumbar radiographs.

Summary of background data: Supine MRI is routinely performed when diagnosing LSS. Standing radiographs are often supplemented to measure spinopelvic angles. Little research has been done on whether LL and SS translate from standing radiographs to supine MRI. Previous studies have trended to significant changes in LL and SS; however, none have been performed exclusively in nondeformity LSS.

Materials and methods: Review of preoperative standing lateral lumbar radiographs and midsagittal T2-weighted supine lumbar MRI in 211 patients with LSS without concomitant degenerative spondylolisthesis, measuring LL (L1-S1), segmental lumbar lordosis (sLL) (L4-S1) and SS, in addition to the anteroposterior diameter and height of the L3 vertebral body. We conducted a reliability study and performed a Pearson's correlation analysis. Data was presented in Bland-Altman plots.

Results: Interobserver reliability was good to excellent, with ICC ranging from 0.77 to 0.94 for all parameters. Statistically significant differences were observed in LL and SS between image modalities. The mean radiographic measurements were as follows: LL 48.9 (SD: 12.8), sLL 32.3 (SD: 8.1), and SS 37.3 (SD: 8.7) degrees. The mean MRI measurements were as follows: LL 46.0 (SD: 10.5), sLL 32.3 (SD: 7.1), and SS 38.1 (SD: 7.1) degrees. Mean vertebral body magnification was between 21% and 23% for L3 anteroposterior diameter and height.

Conclusions: Our results suggest that supine lumbar MRI might be a viable alternative to standing lateral lumbar radiographs for measuring LL and SS in routine follow-up for patients with LSS without concomitant spinal deformity. Standing radiographs are recommended as part of the initial investigation for LSS. Standing lumbar radiographs may yield high grades of magnification.

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腰椎管狭窄症仰卧位MRI与站立位x线片的脊柱骨盆角度及放大比较。

研究设计：基于前瞻性队列研究的放射横断面研究（III级）。目的：探讨非畸形腰椎管狭窄症（LSS）的仰卧位磁共振成像（MRI）和站立位x线片上腰椎前凸（LL）和骶骨倾斜（SS）是否有显著差异。其次，量化站立式腰椎x线片的放大量。背景资料总结：诊断LSS时，常规采用仰卧位MRI。站立x线片常辅助测量脊柱骨盆角。关于LL和SS是否从站立x线片转化为仰卧位MRI的研究很少。以往的研究显示LL和SS有显著变化的趋势；然而，没有一例是专门针对非畸形LSS进行的。材料和方法：回顾211例无退行性椎体滑脱的LSS患者术前站立腰侧位片和正中矢状位t2加权仰卧位MRI，测量LL （L1-S1）、节段性腰椎前凸（L4-S1）和SS，以及L3椎体的前后径和高度。我们进行了可靠性研究，并进行了Pearson相关分析。数据以Bland-Altman图表示。结果：观察者间信度为良好至优秀，所有参数的ICC范围为0.77 ~ 0.94。两种影像模式在LL和SS上的差异有统计学意义。平均x线测量值如下：LL为48.9度（SD: 12.8）， LL为32.3度（SD: 8.1）， SS为37.3度（SD: 8.7）。MRI平均测量值如下：lll 46.0度（SD: 10.5）， sLL 32.3度（SD: 7.1）， SS 38.1度（SD: 7.1）。L3前后径和高度的平均椎体放大率在21%到23%之间。结论：我们的研究结果表明，在常规随访中，对于无脊柱畸形的LSS患者，仰卧位腰椎MRI可能是一种可行的替代站立侧位腰椎x线片测量LL和SS的方法。站立x线片推荐作为LSS初步调查的一部分。站立腰椎x线片可显示高等级的放大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Spine Surgery Medicine-Surgery

CiteScore

3.00

自引率

5.30%

发文量

236

期刊介绍： Clinical Spine Surgery is the ideal journal for the busy practicing spine surgeon or trainee, as it is the only journal necessary to keep up to date with new clinical research and surgical techniques. Readers get to watch leaders in the field debate controversial topics in a new controversies section, and gain access to evidence-based reviews of important pathologies in the systematic reviews section. The journal features a surgical technique complete with a video, and a tips and tricks section that allows surgeons to review the important steps prior to a complex procedure. Clinical Spine Surgery provides readers with primary research studies, specifically level 1, 2 and 3 studies, ensuring that articles that may actually change a surgeon’s practice will be read and published. Each issue includes a brief article that will help a surgeon better understand the business of healthcare, as well as an article that will help a surgeon understand how to interpret increasingly complex research methodology. Clinical Spine Surgery is your single source for up-to-date, evidence-based recommendations for spine care.