Upright vs Supine CT for Spinal Stenosis

Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of Kansas Medical Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial compares two types of CT scans to determine which is more effective for diagnosing spinal stenosis, a condition where spaces in the spine narrow and cause pain. It examines whether standing CT scans (Upright CT), where patients bear their weight, provide doctors with more useful information than the usual lying-down scans. This could benefit individuals unable to undergo an MRI by offering better assessments and treatment for spine problems. Suitable candidates for this trial include those who haven't had lumbar spine surgery and are scheduled for a supine CT myelography. As an unphased trial, it offers participants the chance to contribute to research that could enhance diagnostic options for spinal conditions.

What prior data suggests that this method is safe for evaluating spinal stenosis?

Research has shown that CT myelography is usually easy for patients to handle. This test uses a special dye and X-rays or CT scans to take detailed pictures of the spine. It can sometimes cause mild side effects like headaches or nausea, but these are generally minor and resolve quickly. Studies have not identified any serious safety concerns with this method. Prospective participants should discuss any concerns with their doctor before joining a clinical trial.12345

Why are researchers excited about this trial?

Researchers are excited about the Upright CT technique for spinal stenosis because it allows imaging while the patient is in a natural standing position, which can reveal spinal issues that might not be apparent when lying down. Unlike traditional supine CT scans, the Upright CT can provide a more accurate representation of how the spine behaves under normal, weight-bearing conditions. This method has the potential to improve diagnosis and treatment planning by offering a clearer view of the spinal canal's dynamics when under the pressure of gravity.

What evidence suggests that upright CT is effective for diagnosing spinal stenosis?

This trial will compare Upright CT with Supine CT for detecting spinal stenosis. Studies have shown that CT myelography surpasses MRI in identifying spinal stenosis, with a success rate of 94.4% compared to 75.9%. This indicates that CT myelography is more effective at detecting this condition. However, some research highlights that CT scans can exaggerate the severity of the condition by 20-35%. There is insufficient evidence to determine whether standing CT scans (upright) are more effective than lying down scans (supine) for this condition. The hypothesis is that standing scans might offer more information by showing how the spine appears when supporting weight.16789

Are You a Good Fit for This Trial?

This trial is for adults (18 or older) who are outpatients and already scheduled to have a standard CT myelogram of the lower back, usually due to pinched nerves or spinal stenosis. People unable to undergo MRI may especially benefit.

Inclusion Criteria

I am 18 years old or older.
* Outpatient status
* Scheduled for routine supine CT myelography

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

Imaging

Participants undergo upright and supine CT myelography to evaluate lumbar spinal stenosis

1 day
1 visit (in-person)

Follow-up

Participants are monitored for changes in management plans based on imaging results

1 week

What Are the Treatments Tested in This Trial?

Interventions

  • Upright CT

Trial Overview

The study compares two ways of doing CT myelography: one while standing up (upright/weight-bearing) and one lying down (supine), to see which gives better information about nerve and spine problems in the lower back.

How Is the Trial Designed?

1

Treatment groups

Experimental Treatment

Group I: Upright and Supine CT MyelographyExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Kansas Medical Center

Lead Sponsor

Trials
527
Recruited
181,000+

Citations

Lumbar Spinal Stenosis and Minimally Invasive ... - PMC - NIH

The effective rate of the MILD procedure was reported to be 57.1%–88%. A 2-year postoperative stability of efficacy was also supported. One RCT ...

Effectiveness of upright MRI for evaluation of patients with ...

Committee members found that there was insufficient scientific evidence to make any conclusions about uMRI's effectiveness, including whether ...

Non-surgical treatment options and surgery outcomes in ...

Research: “Spinal surgery failure for spinal stenosis patients is due mainly (61%) to surgical error and nearly 55% from misdiagnosis.” Above we discussed ...

Spinal Stenosis Imaging: Practice Essentials, Radiography, ...

In a study comparing CT and MRI reliability, CT overestimated the degree of stenosis 20-35% of the time, and MRI overestimated the degree of ...

When does CT myelography add value beyond MRI for ...

Prior studies have demonstrated that CT myelography has a greater sensitivity in revealing stenosis (94.4%) compared to MRI (75.9%). However, this is an ...

Prospective Evaluation of Upright Versus Supine CT ...

The purpose of this prospective study is to compare the diagnostic utility of standing (upright, weight-bearing) CT myelography with standard ...

7.

pubmed.ncbi.nlm.nih.gov

pubmed.ncbi.nlm.nih.gov/9709684/

correlation of upright flexion-extension myelography and ...

Results: In 10 of the 33 patients (12 levels), the CT myelogram underestimated spinal stenosis, as compared with the upright flexion-extension myelogram. In 5 ...

Diagnosis of lumbar spinal stenosis in adults - AJR Online

Published studies of the value of CT and MR for the diagnosis of lumbar stenosis lack methodologic rigor and do not permit strong conclusions about the relative ...

Myelography (Myelogram)

Myelography provides a very detailed picture (myelogram) of the spinal cord, nerve roots, subarachnoid space and spinal column. The radiologist ...