Progress in Advanced Imaging Techniques for the Lumbar Spine

Abstract

Low back pain remains challenging to diagnose and treat. There has been considerable progress in advanced spine imaging that has improved the understanding of the anatomy and physiology of the lumbar spine. Advanced imaging can now reveal fundamental properties of lumbar spine tissues and lend insight into the specific chemical, physiological, and mechanical changes that occur with degeneration. Some of these imaging modalities may eventually be used in clinical evaluation and may direct interventional management of patients with low back pain. While there are many novel and exciting developments, very few imaging methods have been applied to the known spine pain syndromes. The advanced imaging methods most amenable to direct clinical application for known spine pain syndromes are fat-suppressed magnetic resonance imaging, T1rho magnetic resonance imaging, and metabolic tracer studies. This paper reviews these imaging methods alongside many others in development; these imaging modalities inform the understanding of the lumbar spine and may be used in the future to assess spine pain syndromes and direct treatment.