Load-Bearing Shifts in Laminar and Ligament Morphology: Comparing Spinal Canal Dimensions Using Supine versus Upright Lumbar MRI in Adults without Back Pain

Abstract

Purpose The effects of weight bearing on lumbar spinal canal dimensions are not well reported the low back pain (LBP) literature. Since axial loading induces changes in anatomical configuration of the lumbar spine, supine spine imaging may not uncover dimensional changes associated with physiological weight bearing that could be demonstrated in imaging in the upright position. Methods This study compared anteroposterior spinal canal dimensions measured at the level of the intervertebral discs in the supine and upright lumbar spine magnetic resonance images in adults without a history or current back pain. Additionally, interlaminar distances were measured between the centers of adjacent laminae involving a spinal segment. These parameters were utilized to ascertain the deformation incurred at the ligamentum flavum due to load bearing. Results Within and between-sessions t -tests, factorial and repeated-measures analysis of variance showed significant alterations in canal dimensions at certain levels, secondary to the upright positioning of the spine. Measurement reliability assessed between sessions and scanning positions using intraclass correlation coefficients demonstrated strong agreement. Conclusion Imaging studies involving physiological weight bearing may be useful to understand the potential etiological effects of such changes in mechanical LBP.