Could compression and traction loading improve the ability of magnetic resonance imaging to identify findings related to low back pain?

Vahid Abdollah; Eric C Parent; Alex Su; Keith Wachowicz; Michele C Battié

doi:10.1016/j.msksp.2020.102250

Could compression and traction loading improve the ability of magnetic resonance imaging to identify findings related to low back pain?

Musculoskelet Sci Pract. 2020 Dec:50:102250. doi: 10.1016/j.msksp.2020.102250. Epub 2020 Sep 3.

Authors

Vahid Abdollah¹, Eric C Parent², Alex Su³, Keith Wachowicz⁴, Michele C Battié⁵

Affiliations

¹ Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, CA T6G 2G4, Canada. Electronic address: v.abdollah@ualberta.ca.
² Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, CA T6G 2G4, Canada. Electronic address: eparent@ualberta.ca.
³ Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 3-48 Corbett Hall, Edmonton, AB, CA T6G 2G4, Canada. Electronic address: asu1@ualberta.ca.
⁴ Department of Oncology, Medical Physics Division, 11560 University of Alberta, Edmonton, AB, CA T6G 1Z2, Canada; Department of Medical Physics, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, CA T6G 1Z2, Canada. Electronic address: kwachowi@ualberta.ca.
⁵ Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, CA T6G 2G4, Canada. Electronic address: mbattie@uwo.ca.

PMID: 32947196
DOI: 10.1016/j.msksp.2020.102250

Abstract

Background: Diagnostic imaging is routinely used to depict structural abnormalities in people with low back pain (LBP), but most findings are prevalent in people with and without LBP. It has been suggested that LBP is related to changes induced in the spine due to loading. Therefore, new imaging measurements are needed to improve our ability to identify structures relating to LBP.

Objectives: To investigate the response of the lumbar spine to compression and traction in participants with and without chronic LBP using MRI T₂-mapping.

Method: Fifteen participants with chronic LBP were matched for age, weight, and gender with 15 healthy volunteers. All participants underwent MRI under three loading conditions maintained for 20 min each: resting supine, followed by compression and traction, both using 50% body weight. Participants were imaged in the last 5 min of each loading condition. Disc morphometric and fluid-based measurements from T₂-maps were obtained.

Results: Traditional MRI measurements (i.e. disc height, width and mean signal intensity) were not able to capture any differences in the changes measured in response to loading between individuals with and without pain. The location of the T₂ weighted centroid (WC) was able to capture the difference between groups in response to compression in the horizontal (p < 0.01) and vertical direction (p < 0.01), and in response to traction in the vertical direction (p < 0.01). While the location of T₂WC moved anteriorly (Effect Size (ES): 0.44) and inferiorly with compression in those with pain (ES: 0.34), it moved posteriorly (ES: -0.14) and superiorly (ES: -0.05) in the group without pain. In response to traction, the vertical location of T₂WC moved superiorly in both groups but the change was larger in those with pain (ES _Pain = -0.52; ES _{No Pain}: -0.13).

Conclusion: The novel measurements of the location of the T₂WC in the intervertebral discs were the only measurements capturing differences in response to loading between those with and without low back pain.

Keywords: Biomarker; Compression; Disc degeneration; Disc height; Intervertebral disc; Loading; Low back pain; Magnetic resonance imaging; T(2) mapping; Traction.

MeSH terms

Humans
Intervertebral Disc Degeneration*
Intervertebral Disc*
Low Back Pain* / diagnostic imaging
Magnetic Resonance Imaging
Traction