Index to Chiropractic Literature
Index to Chiropractic Literature
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Thursday, December 26, 2024
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ID 20348
  Title Repeat upright positional magnetic resonance imaging for diagnosis of disorders underlying chronic noncancer lumbar pain
URL http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=Citation&list_uids=18984246
Journal J Manipulative Physiol Ther. 2008 Oct;31(8):627-631
Author(s)
Subject(s)
Peer Review Yes
Publication Type Article
Abstract/Notes OBJECTIVE: Cases of chronic noncancer pain are both the most frequent and the most difficult that the spine care professional is called upon to treat. We use this case to illustrate the potential effectiveness of repeat positional upright, weight-bearing magnetic resonance (MR) imaging to diagnose disorders and to detect changes in disorders.

CLINICAL FEATURES: We present the case of a 35-year-old man referred to our neurosurgical clinic with complaints of chronic, noncancer lower back pain and right-greater-than-left sciatica. Traditional recumbent MR imaging had revealed degenerative disk disease at L5-S1 and a 2.2-mm (grade 1) degenerative spondylolisthesis. The patient had not improved after more than a year of conservative treatments and, moreover, had been prescribed opiates for pain management that were potentially masking changes in his condition.

INTERVENTION AND OUTCOMES: After referral to our clinic, we ordered repeat lumbar MR imaging in an upright weight-bearing position (sitting) 14 months after the patient's recumbent MR imaging. The weight-bearing MR imaging revealed a 9.13-mm (grade 1) degenerative spondylolisthesis at L5-S1. The patient underwent arthrodesis. His leg pain and back were significantly and clinically improved.

CONCLUSION: When patients with noncancer, lower back pain worsen, fail to improve, or require opiates to manage their pain, updated clinical diagnosis including repeat positional imaging may be an effective diagnostic strategy.

Click on the above link for the PubMed record for this article; full text by subscription. This abstract is reproduced with the permission of the publisher.

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