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Research ArticleSpine

Dynamic Changes in the Dural Sac Cross-Sectional Area on Axial Loaded MR Imaging: Is There a Difference between Degenerative Spondylolisthesis and Spinal Stenosis?

H. Ozawa, H. Kanno, Y. Koizumi, N. Morozumi, T. Aizawa, T. Kusakabe, Y. Ishii and E. Itoi
American Journal of Neuroradiology June 2012, 33 (6) 1191-1197; DOI: https://doi.org/10.3174/ajnr.A2920
H. Ozawa
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H. Kanno
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Y. Koizumi
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N. Morozumi
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T. Aizawa
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T. Kusakabe
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Y. Ishii
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E. Itoi
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    Fig 1.

    The measurement of DCSA on conventional MR imaging and axial loaded MR imaging in representative patients with SpS (A and C) and DS (B and D). The white lines indicate the outlines of the DCSA. In the first patient with SpS, the DCSA changed from 67 (A) to 41 mm2 (C) due to the axial loading. In the second patient with DS, the DCSA changed from 52 (B) to 25 mm2 (D).

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    Fig 2.

    The values of DCSA for conventional MR imaging and axial loaded MR imaging at the most constricted intervertebral levels for each patient in the SpS (A) and the DS (B) groups. The Pearson correlation coefficients between conventional MR imaging and axial loaded MR imaging were 0.97 in the SpS group and 0.88 in the DS group (P < .001).

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    Fig 3.

    Bland-Altman plots for each patient in the SpS (A) and the DS (B) groups. The y-axis shows the difference in the DCSA between conventional MR imaging and axial loaded MR imaging (DCSA in conventional MR imaging − DCSA in axial loaded MR imaging). The x-axis shows the average of the DCSA of the conventional and axial loaded MR imaging [(DCSA in conventional MR imaging + DCSA in axial loaded MR imaging) / 2]. The solid lines indicate the mean differences in the DCSA.

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    Fig 4.

    Comparison of the DCSA obtained by conventional MR imaging and axial loaded MR imaging between the SpS and the DS groups. The asterisk indicates P < .05; error bars, SD.

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    Fig 5.

    Comparison of the change in the DCSA induced by axial loading between the SpS and the DS groups. The asterisk indicates P < .05; error bars, SD.

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    Fig 6.

    Comparison of the DCSA obtained by conventional MR imaging and axial loaded MR imaging between patients with >15- and ≤15-mm2 changes in the DCSA in the SpS (A) and DS (B) groups. The asterisk indicates P < .05; error bars, SD.

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    Table 1:

    Comparison of baseline characteristics between SpS and DS groups

    Baseline CharacteristicsSpS Group (n = 48)DS Group (n = 40)P Valuea
    Age (yr)b68 ± 968 ± 11.730
    Sex (male)69%53%.090
    Height (cm)b161 ± 8159 ± 10.336
    Body weight (kg)b64 ± 1065 ± 13.702
    Body mass index (kg/m2)b25 ± 326 ± 4.251
    Duration of symptoms (mo)b28 ± 3439 ± 31.121
    Presence of low back pain48%50%.508
    The most constricted level.182
        L2/3\n2%\n0%
        L3/421%23%
        L4/563%75%
        L5/S115%3%
    • ↵a There are no statistically significant differences in any parameters between 2 groups.

    • ↵b Values are mean ± SD.

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    Table 2:

    Measurements of the DCSA in all patientsa

    DCSA on Conventional MR ImagingDCSA on Axial Loaded MR Imaging
    1st Measurement56.9 ± 27.843.2 ± 29.3
    2nd Measurement54.7 ± 27.342.6 ± 28.0
    3rd Measurement54.2 ± 26.843.2 ± 28.3
    Averageb55.3 ± 26.843.2 ± 28.2
    • ↵a Values are mean ± SD (mm2).

    • ↵b Average of the 3 measurements.

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    Table 3:

    Prevalence of a >15 mm2 change in the DCSA in SpS and DS groupsa

    SpS Group (n = 48)DS Group (n = 40)
    ≤15 mm2 change in the DCSA40 (83.3%)15 (37.5%)
    >15 mm2 change in the DCSA8 (16.7%)25 (62.5%)
    • ↵a There is a significant difference (χ2 test, P < .001; odds ratio, 8.33).

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American Journal of Neuroradiology: 33 (6)
American Journal of Neuroradiology
Vol. 33, Issue 6
1 Jun 2012
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H. Ozawa, H. Kanno, Y. Koizumi, N. Morozumi, T. Aizawa, T. Kusakabe, Y. Ishii, E. Itoi
Dynamic Changes in the Dural Sac Cross-Sectional Area on Axial Loaded MR Imaging: Is There a Difference between Degenerative Spondylolisthesis and Spinal Stenosis?
American Journal of Neuroradiology Jun 2012, 33 (6) 1191-1197; DOI: 10.3174/ajnr.A2920

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Dynamic Changes in the Dural Sac Cross-Sectional Area on Axial Loaded MR Imaging: Is There a Difference between Degenerative Spondylolisthesis and Spinal Stenosis?
H. Ozawa, H. Kanno, Y. Koizumi, N. Morozumi, T. Aizawa, T. Kusakabe, Y. Ishii, E. Itoi
American Journal of Neuroradiology Jun 2012, 33 (6) 1191-1197; DOI: 10.3174/ajnr.A2920
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