Estudio de la patología lumbar crónica mediante TC con simulación de la bipedestación

Abstract

AimThe purpose of this study was to demonstrate the contribution of lumbar spine CT utilizing upright posture simulation in the study of chronic lumbar pathology. Materials and MethodsThere were studied 52 patients with chronic lumbar pathology and whose conventional lumbar spine CT results had been inconclusive, by means of dynamic CT with GE Pro-Speed SX scanner. There was utilized a traction device which permitted the application of a force at the patient’s shoulders equivalent to half the body weight. Two studies were realized for each patient, one in psoas-relaxed position and another in lumbar traction. Slices obtained were reconstructed for processing. The following parameters were analyzed: spinal canal area, disc area, anteroposterior canal diameter and interpe-dicular distance, foramen height and width. The foramen was studied in parasagital slices. ResultsDynamic CT revealed absolute stenosis in 19 patients and relative stenosis in 26. In 19 patients, there was observed a generalized disc protrusion, and in 15 patients there was evidence of herniated disc. In 40 of the 52 patients studied, dynamic CT provided information additional to that of the preliminary conventional CT diagnosis. ConclusionDynamic lumbar spine CT showed findings undetected in conventional CT. While not a first line imaging tool, it can play an important role for patients with clinical signs of canal stenosis or with chronic low back pain for whom conventional CT does not provide information which accounts for patient symptomatology.