Loading the spine in MRI. What diagnoses are we missing?
revealing more anatomical detail
It is nothing new to learn that low back pain is a worldwide problem, having a leading role in disability days lost.1 MRI plays an important role in identifying underlying problems within the spine, however, there is a debate on its utility as often the symptoms do not match up to the findings.
In a recent paper published in Acta Inform Med2, this original research looked at MRI but in a loaded fashion, similar to what the spine experiences in a vertical state when the spine is most often symptomatic. MRI is conducted lying down, mostly, with some offering upright MRI. However, radiologists argue that the upright MRI has poor resolution. To keep the resolution good, an alternative strategy is to create a simulated gravitational load by strapping the patient lying down.
What did these researchers do?
Loading for alMRI was performed with the DynaWell
L-Spine device (DynaWell Int. AB, Billdal, Sweden). The
onset of loading was 10 minutes before the start of alMRI.
The loading continued throughout the imaging procedure.
The spine was subjected to a load of 50% of the patient’s body
mass, which was equally distributed among the legs (25% of
the patient’s body mass per leg)
What did they find?
Quite simply, these researchers found that when loading the spine, MRI findings changed. Most notably:
- disc height loss
- the discs bulged more from front to back
- the discs bulged more from side to side
Dynamic Disc Designs
At ddd, we create 3d anatomical models demonstrating disc dynamics to educate the patients and professionals on how load affects disc height and the geometrical changes that occur within the spinal tissues. Explore