Abstract
Purpose
This study was designed to determine the association between LSE, spondylolisthesis, facet arthropathy, lumbar canal stenosis, BMI, radiculopathy and bone marrow edema at conventional lumbar spine MR imaging.
Methods
This is a retrospective radiological study; 441 consecutive patients with low back pain (224 men and 217 women; mean age 57.3 years; mean BMI 26) underwent conventional lumbar MRI using a 1.5-T magnet (Avanto, Siemens). Lumbar MR images were reviewed by consensus for the presence of LSE, spondylolisthesis, facet arthropathy, lumbar canal stenosis, radiculopathy and bone marrow edema. Descriptive statistics and association studies were conducted using STATA software 11.0. Association studies have been performed using linear univariate regression analysis and multivariate regression analysis, considering LSE as response variable.
Results
The overall prevalence of LSE was 40 %; spondylolisthesis (p = 0.01), facet arthropathy (p < 0.001), BMI (p = 0.008) and lumbar canal stenosis (p < 0.001) were included in the multivariate regression model, whereas bone marrow edema, radiculopathy and age were not.
Conclusions
LSE is highly associated with spondylolisthesis, facet arthropathy and BMI, suggesting underestimation of its clinical impact as an integral component in chronic lumbar back pain. Longitudinal simultaneous X-ray/MRI studies should be conducted to test the relationship of LSE with lumbar spinal instability and low back pain.
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References
D’Aprile P, Tarantino A, Jinkins JR et al (2007) The value of fat saturation sequences and contrast medium administration in MRI of degenerative disease of the posterior/perispinal elements of the lumbosacral spine. Eur Radiol 17:523–531
Lubrano E, Astorri D, Taddeo M et al (2013) Rehabilitation and surgical management of ankylosing spondylitis. Musculoskelet Surg 97(Suppl 2):S191–S195
Cicala D, Briganti F, Casale L et al (2013) Atraumatic vertebral compression fractures: differential diagnosis between benign osteoporotic and malignant fractures by MRI. Musculoskelet Surg 97(Suppl 2):S169–S179
Quattrocchi CC, Giona A, Di Martino AC et al (2013) Extra-spinal incidental findings at lumbar spine MRI in the general population: a large cohort study. Insights Imaging 4:301–308
Mohanty SP, Bhat SN, Ishwara-Keerthi C (2011) The effect of posterior instrumentation of the spine on canal dimensions and neurological recovery in thoracolumbar and lumbar burst fractures. Musculoskelet Surg 95:101–106
Erfani MA, Pourabbas B, Nouraie H, Vadiee I, Vosoughi AR (2014) Results of fusion and instrumentation of thoracic and lumbar vertebral fractures in children: a prospective ten-year study. Musculoskelet Surg 98:107–114
Rawall S, Mohan K, Nene A (2013) Posterior approach in thoracolumbar tuberculosis: a clinical and radiological review of 67 operated cases. Musculoskelet Surg 97:67–75
Lakadamyali H, Tarhan NC, Ergun T et al (2008) STIR sequence for depiction of degenerative changes in posterior stabilizing elements in patients with lower back pain. Am J Roentgenol 191:973–997
Shi H, Schweitzer ME, Carrino JA et al (2003) MR imaging of the lumbar spine: relation of posterior soft-tissue edema-like signal and body weight. Am J Roentgenol 180:81–86
Cooper M, Hacking JC, Dixon AK (1995) Sacral edema: computed tomographic and anatomical observations. Clin Anat 8:56–60
Kim NR, Hong SH, Choi JY et al (2010) Spreading epidural hematoma and deep subcutaneous edema: indirect MRI signs of posterior ligamentous complex injury in thoracolumbar burst fractures. Skelet Radiol 39:767–772
Chatha DS, Schweitzer ME (2011) MRI criteria of developmental lumbar spinal stenosis revisited. Bull NYU Hosp Jt Dis 69:303–307
Binder KD, Schmidt MH, Weinstein P (2002) Lumbar spinal stenosis. Sem Neurol 22:157–166
Katz JN, Harris MB (2008) Lumbar spinal stenosis. N Engl J Med 358:818–825
Chad DA (2007) Lumbar spinal stenosis. Neurol Clin 25:407–418
Herzog RJ, Kaiser JA, Saal JA et al (1991) The importance of posterior epidural fat pad in lumbar central canal stenosis. Spine 16:S227–S233
Crosby CG, Even JL, Song Y et al (2011) Diagnostic abilities of magnetic resonance imaging in traumatic injury to the posterior ligamentous complex: the effect of years in training. Spine J 11:747–753
Vaccaro AR, Rihn JA, Saravanja D et al (2009) Injury of the posterior ligamentous complex of the thoracolumbar spine: a prospective evaluation of the diagnostic accuracy of magnetic resonance imaging. Spine 34:E247–E841
Reicher MA, Gold RH, Halbach VV et al (1986) MR imaging of the lumbar spine: anatomical correlations and the effects of technical variations. Am J Roentgenol 147:891–898
Jensen MC, Brant Zawadzki MN et al (1994) Magnetic Resonance Imaging of the Lumbar Spine in people without back pain. N Engl J Med 331:69–73.
Jakoi A, Kumar N, Vaccaro A, Radcliff K (2014) Perioperative coagulopathy monitoring. Musculoskelet Surg 98:1–8
Papalia R, Di Pino G, Tecame A et al (2015) Biomechanical and neural changes evaluation induced by prolonged use of non-stable footwear: a systematic review. Musculoskelet Surg [Epub ahead of print]
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Quattrocchi, C.C., Giona, A., Di Martino, A. et al. Lumbar subcutaneous edema and degenerative spinal disease in patients with low back pain: a retrospective MRI study. Musculoskelet Surg 99, 159–163 (2015). https://doi.org/10.1007/s12306-015-0355-2
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DOI: https://doi.org/10.1007/s12306-015-0355-2