The Value of Standing X-ray in Detecting Physiological Spondylolisthesis in Patients with Single Disc Prolapse with Normal Intensity MRI Findings

Abstract

Najat Adel Hashim, Raad Jawad Kadhim.

Background: A common spinal disease is lumbar disc herniation (LDH) accompanied by clinically relevant symptoms and it affects nearly one to 3 percent of general population. It has been inferred from long-term studies that approximately 15 percent of patients with spondylosis will have spondylolisthesis in addition. When adults are taken into consideration, 10% women and 5% of men are going to have lumbar spondylolisthesis that is not accompanied by a defect in the pars. Aim of the study: The current study was carried out in order to highlight the association between physiologic spondylolisthesis and disc herniation.
Patients and methods: The current cross-sectional study was carried out at radiology unit, Al-Diwaniyah teaching hospital, Al-Diwaniyah province, Iraq. The work with this study is dated back to March 2019 and lasted till April 2020. The study included 100 patients with single disc prolapsed, who were randomly selected from the pool of patients referred by orthopedic unit to radiology unit. Those patients were investigated by MRI according to the routinely recommended examination done in the radiology unit for patients with single disc prolapse in addition to conventional plane x-ray in supine and standing positions (anteroposterior and lateral).
Results: The following results were found after data evaluation. Regarding the age interval of 20-40, 15 of them have disk prolapse with normal signal intensity, no one of them have spondylolisthesis, and 5 of them have abnormal signal intensity (dehydrated disk), one patient showing spondylolisthesis. Regarding the age interval of 41 to 60, 18 of them have disk prolapse with normal signal intensity, no one of them have spondylolisthesis, and 42 of them have abnormal signal intensity (dehydrated disk), 4 patient showing spondylolisthesis. With respect to the age above 60, one of them are have disk prolapsed with normal signal intensity, no one of them have spondylolisthesis, and 19 of them have abnormal signal intensity (dehydrated disk), one patient showing spondylolisthesis.
Conclusion: standing position lateral X-ray must be performed for every patient with single disk prolapse having normal or abnormal signal intensity MRI to exclude physiological spondylolisthesis.