Axial loading of the spine during CT and MR in patients with suspected lumbar spinal stenosis

Acta Radiol. 1998 Nov;39(6):604-11. doi: 10.3109/02841859809175484.


Purpose: To evaluate the effect of compressive axial loading in imaging of the lumbar spine in patients with clinically suspected spinal stenosis.

Material and methods: A total of 84 patients were examined, 50 with CT (after intrathecal contrast administration) and 34 with MR. First the dural sac cross-sectional area (CSA) was determined with the patient in the supine psoas relaxed position (PRP). Then the CSA was determined during supine axial compression in slight extension (ACE), obtained with a specially designed loading device. A measurement error study was performed.

Results: A minimum difference in CSA of 15 mm2 between PRP and ACE was found to be significant. In 40/50 (80%) of CT-examined patients and in 26/34 (76%) of MR-examined patients a significant difference in CSA was found. In 25/84 (30%) of the patients there was a significant difference at more than one level.

Conclusion: For an adequate evaluation of the CSA, CT or MR studies should be performed with axial loading in patients who have symptoms of lumbar spinal stenosis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Compressive Strength
  • Female
  • Humans
  • Intervertebral Disc Displacement / complications
  • Intervertebral Disc Displacement / diagnosis
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology*
  • Lumbar Vertebrae / physiopathology
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Spinal Osteophytosis / complications
  • Spinal Osteophytosis / diagnosis
  • Spinal Stenosis / diagnosis*
  • Spinal Stenosis / etiology
  • Spinal Stenosis / physiopathology
  • Supine Position
  • Tomography, X-Ray Computed / methods*
  • Weight-Bearing*