Researchers found in a recent study in the Journal of Neurosurgery: Spine that, when combined with image fusion, an improved magnetic resonance myelography approach more accurately aided surgeons in diagnosing patients with lumbar spinal stenosis than post-myelographic CT scans.
“An optimized [magnetic resonance] MR myelography approach—a dedicated 3-D MR myelography sequence in combination with image fusion—is required to achieve a more reliable diagnosis of lumbar spine stenoses compared with post-myelographic CT, especially in cases of severe compression, compared with post-myelographic CT,” Knut Eberhardt, MD, and colleagues wrote in the study. “This MR myelography approach may be helpful in preventing overestimation of lumbar spine stenoses.”
Eberhardt and colleagues evaluated 50 patients with suspected lumbar spinal stenosis who underwent both a post-myelographic CT and MR myelography approach using a 3-D MRI sequence and image fusion, according to the abstract. Although there were no significant differences for volumes and dural areas in normal lumbar levels, the researchers found significantly larger dural volume in L4-5 and L5- S1, but not L2-3 and L3-4. In patients with lumbar stenosis, MR myelography indicated significantly larger dural volume in all four lumbar levels.
“The upper limits of 99% [confidence intervals] CIs for stenotic levels can be interpreted as an indication for surgical treatment,” the investigators wrote. “However, further studies that include postoperative outcomes are required,” they noted. – by Jeff Craven
Disclosure: The authors have no relevant financial disclosures.