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The influence of knee bolster on lumbar spinal stenosis parameters on MR images

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Abstract

Objective

To estimate the effect of the knee bolster use during an MRI on lumbar spinal stenosis parameters and low back pain-related disability.

Methods

A repeated-measurement study of 27 males and 19 females with mean age 55.78 ± 14.36, referred for an MRI of the lumbar spine due to low back pain, performed with and without standard knee bolster. A radiologist evaluated the lumbar lordosis Cobb’s angle, the cross-sectional area of the right and left intervertebral foramina and spinal canal at L1-L2, L2-L3, L3-L4 spinal levels. Spinal symptoms were evaluated by the Oswestry Disability Questionnaire.

Results

The Cobb angle of lumbar lordosis was found significantly greater on an MRI performed without knee bolster than with bolster (47.30 ± 9.90 vs. 42.57 ± 10.62, p < 0.001). The cross-sectional area of the intervertebral foramina and spinal canal at all evaluated levels was smaller when performed without knee bolster than with bolster. However, differences were significant only at the L1-L2 level and in the spinal canal at all evaluated levels. The Cobb angle, measured with and without knee bolster, showed significant positive correlations with back pain while standing and walking. The spinal canal area without knee bolster showed greater correlations with the Oswestry score parameters than with knee bolster.

Conclusions

MR images at evaluated spinal levels taken without knee bolster showed greater correlations of the spinal canal cross-sectional area with the Oswestry score than ones with knee bolster. Thus, one may prefer MR images acquired without a bolster below the knee compared to an MRI with a knee bolster.

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Acknowledgements

The authors thank Mrs. Phyllis Curchack Kornspan for her editorial services.

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Authors and Affiliations

  1. Department of Radiology, Barzilai Medical Center, Ashkelon, Israel

    Azaria Simonovich, Anna Nagar Osherov & Lina Linov

  2. Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev|, POB 653, 84105, Beer Sheva, Israel

    Leonid Kalichman

Authors
  1. Azaria Simonovich
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  2. Anna Nagar Osherov
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  3. Lina Linov
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  4. Leonid Kalichman
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Correspondence to Leonid Kalichman.

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The authors declare that they have no conflicts of interest.

Ethical approval

The study was approved by the Bioethics Institutional Review Board Committee in a public hospital clinical of the Barzilai University Medical Center, Ashkelon, Israel (approval number 0061–15-BRZ).

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Informed consent was obtained from the patients prior to the study.

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Simonovich, A., Nagar Osherov, A., Linov, L. et al. The influence of knee bolster on lumbar spinal stenosis parameters on MR images. Skeletal Radiol 49, 299–305 (2020). https://doi.org/10.1007/s00256-019-03287-w

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  • DOI: https://doi.org/10.1007/s00256-019-03287-w

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