Gyeong Deok Jo et al. explored the impact of the scanning order of axial T2-weighted MR images (T2WIs) on spinal stenosis grading and lumbar anatomical measurements. Conducted on 45 patients with low back pain, the study compared pre-sagittal and post-sagittal axial T2WIs using a 1.5T scanner. Using AVIEW for quantitative analysis, measurements included cross-sectional areas of the spinal canal (SCCSA), dural sac (DSCSA), cerebrospinal fluid (FCSA), and ligamentum flavum (LFCSA). While stenosis grades for the central canal (CCS) and lateral recess (LRS) remained unaffected, DSCSA and FCSA were larger, and LFCSA was smaller in post-sagittal scans, with differences under 5%. The findings suggest minimal clinical impact of scanning order but emphasize that pre-sagittal imaging may better reflect physiological conditions. Limitations include variable ambulation time and body mass index (BMI) data. Future studies should explore optimized scanning protocols and evaluate the role of axial loading in spinal stenosis assessment.
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