An article recently published in The Spine Journal examines conventional supine magnetic resonance imaging as well as standing lateral and flexion-extension radiographs.
Researchers examined 103 patients with an average age of 66 years old. The patients were tested for lumbar degenerative spondylolisthesis. The researchers found:
• Lumbar degenerative spondylolisthesis occurred in 98 percent lateral films while occurring only 78 percent of MRIs.
• Average slip was 10 mm for lateral standing radiographs and 6.6 mm for MRI
• There were 48 percent of the patients identified with mobile lumbar degenerative spondylolisthesis.
• Positive predictive value of facet joint effusion for mobile lumbar degenerative spondylolisthesis increased from 52 percent for infusion greater than 1 mm to 100 percent for patients with effusions greater than 3.5 mm.
• The findings suggest the complete workup of patients with lumbar degenerative spondylolisthesis should include standing radiographs, according to the study authors.
A separate 2005 study examining MRI for adults with low back pain shows most degenerative abnormalities were associated with low back pain and the strongest associations were noted for Modic changes and anterolisthesis. Hypointense disc signal, annular tears, high intensity zones, disc protrusions, endplate changes, zygapophyseal joint degeneration, asymmetry and foraminal stenosis were relatively common.