Jan Willén MD, Presenter: Nothing to Disclose

Barbro I Danielson MD, Abstract Co-Author: Nothing to Disclose

Axial loading during imaging can narrow the lumbar spinal canal especially in patients with different kinds of degenerative spinal stenosis. This has been shown in previous studies. However, the clinical significance from the surgical point of view has not been verified.The purpose of the present study was to evaluate whether occult stenosis, in patients with neurogenic claudication and/or sciatica, detected during axially loaded CT and MR imaging could lead to successful surgical results.

250 patients with signs of neurogenic claudication or sciatica fulfilling the inclusion criteria for axial loaded imaging ( dural sac cross sectional area less than 110 mm2, suspected central or lateral canal during unloaded imaging) were examined until year 2002. 150 showed additional valuable information including 35 patients with occult spinal stenosis in 1-3 disc levels not detected at the traditional examination.The 35 patients were followed up at least 1 year after decompression with or without fusion. Validated outcome instruments were used.

85 per cent of the 35 patients were satisfied with the surgical result. 80 % had no persisting leg pain and 90 per cent could walk more than 1000 m compared to less than 100 m up to 500 m preoperatively. 70 per cent could stand more than 60 min (60 % were back in work. (30 per cent were age pensioned).

The clinical effect of axial loading of the lumbar spine during CT and MR imaging could be proven in this study, which shows that occult spinal stenosis can be detected and lead to successful surgical results.

B.I.D.: Med dir for the company producing the compression device used in the study - no funding

Willén, J, Danielson, B, The Surgical Result in Occult Lumbar Spinal Stenosis Detected by Axial Loaded CT and MRI.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4415478.html