title: Magnetic resonance imaging of the lumbar spine with axial loading: a review of 120 cases.
abstract: OBJECTIVE
  To evaluate the imaging findings of patients with clinical symptoms of lower back pain who underwent magnetic resonance imaging (MRI) of the lumbar spine with axial loading.
  
  
  METHODS
  We examined 120 patients by MRI, before and after axial loading, using a compression device that applied 50% of their body weight for a load time of 5min. The dural sac cross area (DSCA) was examined by two experienced radiologists before and after axial load, and their findings were compared. Degenerative abnormalities within and adjacent to the spinal canal were also analyzed.
  
  
  RESULTS
  A reduction in DSCA greater than 15mm(2) after axial load was defined as significant, and was found in 81 patients (67.5%) and 138 disc spaces (38.3%). Reduction was most frequent at L4-L5 (n=55). For other disorders, a 9% increase in cases of bulging disc was seen during axial loading, and seven disc spaces showed protrusion/extrusion only after load. Facet joint synovial cysts, foraminal stenosis, and hypertrophy of the flavum ligaments showed almost no differences, pre- and post-load.
  
  
  CONCLUSIONS
  For adequate evaluation of lumbar symptoms, examination should be performed with axial loading, especially in cases of suspected spinal stenosis.
authors: Department of Radiology, Federal University of Rio de Janeiro School of Medicine, Rio de Janeiro, Brazil. kinder.andre@gmail.com
authors: Andre
authors: A
authors: Kinder
authors: Fernando Palma
authors: FP
authors: Filho
authors: Elisio
authors: E
authors: Ribeiro
authors: Romeu C
authors: RC
authors: Domingues
authors: Roberto C
authors: RC
authors: Domingues
authors: Edson
authors: E
authors: Marchiori
authors: Emerson
authors: E
authors: Gasparetto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000209:etiology*; D008159:Lumbar Vertebrae / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010812:Physical Stimulation / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013130:Spinal Stenosis / Q000150:complications* / Q000175:diagnosis*; D016474:Weight-Bearing