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Lumbar disk protrusion rates of symptomatic patients using magnetic resonance imaging

John W Gilbert1, J Chad Martin, Greg R Wheeler

  • 1Neurosurgeon and Neuroimagist, Spine and Brain Neurosurgical Center, Lexington, KY 40522-2430, USA. correspondence@sbncmd.com

Journal of Manipulative and Physiological Therapeutics
|November 2, 2010
PubMed
Abstract

Insights

Magnetic resonance imaging (MRI) detected disk protrusions in symptomatic patients more frequently when scanned in an upright, weight-bearing position (73.3%) compared to a recumbent position (50.1%). This highlights the importance of position-dependent imaging for spine pain evaluation.

Area of Science:

  • Radiology
  • Spine Imaging
  • Diagnostic Medicine

Background:

  • Spine-related pain, radiculopathy, and other symptoms necessitate accurate diagnostic imaging.
  • Magnetic Resonance Imaging (MRI) is a key tool for visualizing spinal structures.
  • The influence of patient positioning on MRI findings for spinal conditions is an area of ongoing research.

Purpose of the Study:

  • To quantify the detection rate of disk protrusions using MRI in patients experiencing symptomatic spine pain.
  • To compare the diagnostic yield of disk protrusions between upright (weight-bearing) and recumbent MRI scans.

Main Methods:

  • A retrospective analysis of 1983 MRI scans from 1486 symptomatic patients over two years.
  • Scans were performed using low-field (0.3 T) recumbent MRI and mid-field (0.6 T) upright open MRI.
  • Data was collected on disk protrusion incidence based on patient position during imaging.

Main Results:

  • Disk protrusions were identified in 73.3% of upright scans versus 50.1% of recumbent scans.
  • The most common sites for protrusions were L5-S1, L4-L5, and L3-L4, with higher rates in the upright position.
  • Upright imaging revealed significantly higher rates of disk protrusions across all evaluated spinal levels.

Conclusions:

  • The incidence of disk protrusions in symptomatic patients is higher in weight-bearing (upright) MRI scans compared to recumbent scans.
  • These findings support the utility of upright MRI in evaluating patients with persistent spine pain.
  • Positional imaging may enhance the detection of spinal abnormalities contributing to patient symptoms.

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