| The distended facet sign: an indicator of position-dependent spinal stenosis and degenerative spondylolisthesis. | |
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MedLine Citation:
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PMID: 17321977 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND CONTEXT: Symptoms of spinal stenosis are position-dependent. Stand up magnetic resonance imaging (MRI) and myelography can demonstrate further dynamic components of spinal stenosis that may go unrecognized on supine MRI. PURPOSE: To describe a radiographic finding seen on standard supine MRI that is an indicator for dynamic spinal stenosis and degenerative spondylolisthesis. STUDY DESIGN/SETTING: Case series. PATIENT SAMPLE: Six patients. OUTCOMES MEASURES: Radiographic observation. METHODS: Six patients with classic neurogenic claudication but equivocal supine MRI findings were evaluated with myelography. The imaging findings were reviewed and compared. RESULTS: All patients had severe position-dependent spinal stenosis upon upright myelographic imaging with grade I or II spondylolisthesis. The MRI showed very minimal to no spondylolisthesis. These dynamic slips reduced when supine, causing the vertebral bodies to appear aligned with adequate canal space, whereas the irregular facet joints became distended. Hypertrophic and fluid-filled facets at the dynamic slip level were seen in all patients, giving the appearance of a distended joint. CONCLUSIONS: MRI may not demonstrate significant stenosis in patients with neurogenic claudication caused by dynamic degenerative spondylolisthesis. However, the presence of large fluid-filled facet joints indicates the likelihood of positional translation at that level which could be further confirmed by upright imaging. |
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Authors:
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Peleg Ben-Galim; Charles A Reitman |
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Publication Detail:
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Type: Journal Article Date: 2006-11-20 |
Journal Detail:
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Title: The spine journal : official journal of the North American Spine Society Volume: 7 ISSN: 1529-9430 ISO Abbreviation: Spine J Publication Date: 2007 Mar-Apr |
Date Detail:
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Created Date: 2007-02-26 Completed Date: 2007-05-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101130732 Medline TA: Spine J Country: United States |
Other Details:
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Languages: eng Pagination: 245-8 Citation Subset: IM |
Affiliation:
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Department of Orthopedic Surgery, Baylor College of Medicine, 1709 Dryden, 12th Floor, Houston, TX 77030, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Female Humans Magnetic Resonance Imaging / methods* Middle Aged Myelography / methods Posture* Spinal Stenosis / radiography* Spondylolisthesis / radiography* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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