Published online Jan 18, 2022. doi: 10.5312/wjo.v13.i1.87
Peer-review started: June 14, 2021
First decision: October 18, 2021
Revised: November 2, 2021
Accepted: January 5, 2022
Article in press: January 5, 2021
Published online: January 18, 2022
Processing time: 216 Days and 19.2 Hours
Biomechanics of the individual lumbar spine structures are important since the overall spinal adaptation to compressive forces is comprised of the cumulative changes of respective elements.
There is a lack of works simultaneously comparing dural sac size, ligamenta flava thickness, foraminal dimensions and lumbar sagittal alignment between axial loaded and recumbent magnetic resonance imaging (MRI) in an extensive group of lower back pain patients.
To help the surgeons in the choice of the spinal endoscopy and spinal injections. The objective of the study was to evaluate the changes depicted by MRI of chosen lumbar spine structures upon axial-loading in comparison with recumbent MRI.
The study covered 90 individuals assessed with three-dimensional volume isotropic acquisition MRI, first imaged in the supine position with no axial load and then again following application of an axial compressive load. Based on recumbent MRI as well as axial-loaded ones, the following were measured: the dural sac area, the ligamenta flava, the intervertebral foramina from L1-L2 to L5-S1 and the lumbosacral angle.
We found out that axial loading intensifies the narrowing of the spinal canal, thickens the ligamenta flava, narrows the intervertebral foramina from L1-L2 to L4-L5 and exaggerates lumbar lordosis.
Our study reveals that there is a correlation between force compression and intensification of the lumbar spinal stenosis, intervertebral foramina narrowing, ligamenta flava thickening as well as increasing lumbar lordosis due to axial loading.
There is a need to introduce computational approaches in automatic image recognition based on machine learning and deep learning to ease radiological measurements of the lumbar spine and obtain a good level of clinical prediction. Moreover, it is worth proposing axial-loading MRI as an elasticity imaging: an innovative “elastography” method designed for the lumbar spine to explore the age of the spine and the percentile grids of degenerative changes.