J Korean Orthop Assoc.  2009 Dec;44(6):604-612. 10.4055/jkoa.2009.44.6.604.

Validity of Repeated MRI in Degenerative Lumbar Disease with Conservative Management

• Kim JO
• Park BJ
• Choi BW
• Song KJ
• Choi BR
• Yang YH

• KMID: 2186286
• DOI: http://doi.org/10.4055/jkoa.2009.44.6.604

Abstract

PURPOSE
This study examined the value and indications of repeated MRI in degenerative lumbar diseases under conservative management by comparing the primary MR and repeated MR images with respect to the symptomatic and radiological changes.
MATERIALS AND METHODS
Seventy patients with degenerative lumbar disease under conservative management underwent repeat MRI. Five MRI findings, including disc, foramen, facet joint, nerve root, and ligamentum flavum, were used to examine the difference between the initial and repeat MRI. The severity was graded using a four-point scale for each item. The patients were divided into 3 groups in order to compare the radiological changes and symptomatic changes, as follows; Group I no change from the initial symptoms (38 cases), Group II aggravation of the initial pain (18 cases), and Group III aggravation of the initial neurology or the development of a new neurology (14 cases).
RESULTS
The mean scores of each item the disc, foramen, facet joint, nerve root and ligamentum flavum increased from 1.76, 1.31-1.79, 1.71, and 1.47, respectively, to 1.90, 1.47, 1.80, 1.79, and 1.53, respectively. Group III showed the greatest proportion of cases with an increasing grading score (78%, 11 cases) only the disc was significant.
CONCLUSION
Repeat MRI in degenerative lumbar disease under conservative management was found to be valuable only in cases with aggravated neurological symptoms, and was not relevant in cases with persistent symptoms or aggravated pain alone.

Keyword

Degenerative lumbar disease; Repeat MRI; Validity

MeSH Terms

Humans
Ligamentum Flavum
Neurology
Zygapophyseal Joint

Figure

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  Fig. 1 The seventy-three year old male performed repeat MRI on 7 months interval due to Rt. sciatic symptom and motor weakness aggravation (Group III). The grading scores of each parameter were increased from disk 2, foramen 2, facet joint 2, and nerve root 2, ligamentum flavum 1 (A, B) to 3, 3, 2, 3, 1 (C, D) respectively.

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  Fig. 2 The fifty-nine year old male performed repeat MRI on 14 months interval due to the symptom persistent (Group I). The grading scores of each parameter were decreased from disk 3, foramen 1, facet joint 1, and nerve root 3, ligamentum flavum 1 (A, B) to 2, 1, 1, 2, 1 (C, D) respectively.

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