Yonsei Med J.  2005 Dec;46(6):806-811.

Comparison of the Predictive Value of Myelography, Computed Tomography and MRI on the Treadmill Test in Lumbar Spinal Stenosis

Affiliations
  • 1Department of Orthop Surg, Yongdong Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
  • 2Department of Orthop Surg, Cha University College of Medicine, Sungnam, Korea.
  • 3Department of Orthop Surg, National Health Insurance Corporation Ilsan Hospital, Koyang, Korea.
  • 4Department of Orthop Surg, Jaesaeng Hospital, Sungnam, Korea.
  • 5The BK 21 Project for Medical Science in Yonsei University, Seoul, Korea.

Abstract

To date, there have been no prospective, objective studies comparing the accuracy of the MRI, myelo-CT and myelography. The purpose of this study is to compare the diagnostic and predictive values of MRIs, myelo-CTs, and myelographies. Myelographies with dynamic motion views, myelo-CTs, MRIs and exercise treadmill tests were performed in 35 cases. The narrowest AP diameter of the dural sac was measured by myelography. At the pathologic level, dural cross-sectional area (D-CSA) was calculated in the MRI and Myelo-CT. The time to the first symptoms (TAF) and the total ambulation time (TAT) were measured during the exercise treadmill test and used as the standard in the comparison of correlation between radiographic parameters and walking capacity. The mean D-CSA by CT was 58.3 mm2 and 47.6 mm2 by MRI. All radiographic parameters such as AP diameters and D-CSA have no correlation to TAF or TAT (p > 0.05). Our data showed no statistically significant differences in the correlation of the patients' walking capacity to the severity of stenosis as assessed by myelography, myelo-CT and MRI.

Keyword

Spinal stenosis; myelography; spiral computed tomography; magnetic resonance imaging; exercise test; predictive value of tests

MeSH Terms

*Tomography, X-Ray Computed
Spinal Stenosis/*diagnosis/pathology/radiography
Predictive Value of Tests
*Myelography
Middle Aged
Male
*Magnetic Resonance Imaging
*Lumbar Vertebrae/pathology/radiography
Humans
Female
*Exercise Test
Aged

Figure

  • Fig. 1 Lateral projections of functional myelogram from a patient with lumbar spinal stenosis in (A) provoked flexion, and (B) extended position. Note the increase of the sagittal diameter at the third and fourth level in the flexed position.

  • Fig. 2 (A) The CT scan slices chosen were parallel to the lower vertebral endplate. The pathologic D-CSA was measured at the disc level. (B) The MRI scan slices chosen were parallel to the lower vertebral endplate. The pathologic D-CSA was measured at the disc level.


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