When at least one of these subsystems is compromised, lumbar spine movement can become abnormal, which can be detected through qualitative and quantitative assessments, such as self-reporting of symptoms and radiographic techniques. Lumbar spine stability is achieved through the combination of three control subsystems passive, active and neural control. Lumbar spinal stability is the ability of the lumbar spine to tolerate displacement during normal physiological postures and loads without the generation of nociceptive stimuli.
Thai Clinial Trial Registry (TCTR 20180820001 19th August 2018). We recommend physical therapists use these three tests to assess patients who are suspected of having lumbar instability, in the absence of an x-ray assessment, to receive appropriate targeted intervention or referral for further investigation. These three tests are simple to perform by physical therapists, reliable to use in a clinical setting, and safe for patients. These 3 clinical tests could be useful in identifying patients with lumbar instability in the general community. At this probability threshold, sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (−LR) were 5.56, 99.18%, 6.78, and 0.95. Three clinical tests i) interspinous gap change during flexion-extension, ii) passive accessory intervertebral movement tests, iii) posterior shear test demonstrated an ability to diagnose lumbar instability of 67% when they were all positive. ResultsĮighteen (12.85%) participants had radiological lumbar instability. Data were analysed using multivariate regression methods to determine which clinical tests were most diagnostic for lumbar instability when they were applied together. One hundred forty participants with chronic low back pain underwent an x-ray assessment and 14 clinical examinations. This study was a cross-sectional, diagnostic validity study. The aim of this study was to identify the probability to diagnose patients with lumbar instability, using x-ray imaging as the reference standard. To augment the diagnostic process, tests that are better able to identify lumbar instability suitable for use in the clinical setting are required.
propylene glycol peak: resonates at 1.13 ppm.
N-acetylaspartate (NAA) peak: resonates at 2.0 ppm.glutamine-glutamate peak: resonates at 2.2-2.4 ppm.gamma-aminobutyric acid (GABA) peak: resonates at 2.2-2.4 ppm.2-hydroxyglutarate peak: resonates at 2.25 ppm.arterial spin labeling (ASL) MR perfusion.dynamic contrast enhanced (DCE) MR perfusion.dynamic susceptibility contrast (DSC) MR perfusion.metal artifact reduction sequence (MARS).turbo inversion recovery magnitude (TIRM).fluid attenuation inversion recovery (FLAIR).diffusion tensor imaging and fiber tractography.MRI pulse sequences ( basics | abbreviations | parameters).iodinated contrast-induced thyrotoxicosis.iodinated contrast media adverse reactions.clinical applications of dual-energy CT.as low as reasonably achievable (ALARA).If the TE is extended out over a very long time, only tissues with a very long T2 relaxation time will retain signal. Gadolinium shortens T2 relaxation time and actually results in hypointense signal. gadolinium-containing compounds) do not cause the same bright tissue contrast as they do on T1WI. The refocusing pulse on spin-echo sequences helps to mitigate these extraneous influences on the T2 relaxation time, trying to keep the image T2 weighted rather than T2* weighted. This additional effect is captured on T2*. The amount of T2 decay a tissue experiences depends on multiple factors. Each tissue has an inherent T2 value, but external factors (such as magnetic field inhomogeneity) can decrease the T2 relaxation time. at the same time, spins are decaying from their aligned precession in the transverse plane - differences in this decay are captured on T2 weighting.after an RF excitation pulse, there is relaxation of the spins from the transverse plane toward the main longitudinal magnetic vector (B 0) - this is T1 weighting.One way to think about T2 relaxation is as follows:
T2 weighting tends to require long TE and TR times. flip angle: less important than with T1 weightingĪ T2WI relies upon the transverse relaxation (also known as "spin-spin" relaxation) of the net magnetization vector (NMV).The sequence weighting highlights differences on the T2 relaxation time of tissues. T2 weighted image ( T2WI) is one of the basic pulse sequences on MRI.