Spondylolisthesis Undetected by Recumbent MRI
A 57-year old woman presented with pain of one year's duration
following failed back surgery performed in 2001*.
The patient continued to experience persistent low back-pain,
accompanied by sensations of coldness and numbness in both
thighs and legs. The patient often required mechanical support
to stabilize her walking.
During the year following surgery, the
patient sought help from multiple medical specialists. She
provided her recumbent MRI images to them. She was told the
images showed nothing that could account for her symptoms
and that nothing more could be done. Her surgeon rejected
the prospect of additional surgery. A Florida neurologist
suggested to her that her problem was “in her head.”
Recumbent on Left - Upright on
The imaging center that evaluated her
recommended she be scanned in an Upright™ MRI due to
the possibility that an Upright™ scan, unlike the conventional
recumbent scan, is weight-bearing and "might uncover
something." Her family physician wrote the prescription,
and the patient drove from her home in the Florida panhandle
to the closest FONAR Upright™ MRI center, which at the
time was in Tampa over 425 miles away.
The patient was scanned in the patented
FONAR Upright™ MRI in early 2002, one year after her
spinal fusion. Both Upright™ and recumbent scans were
performed on her in the multi-position FONAR Upright™
The recumbent MRI (left image) exhibited
only a normal lumbar lordotic curve and a modest bulge of
the L3-4 intervertebral disc, consistent with her prior recumbent
MRI scans. The FONAR Upright™ scan (right image) revealed,
however, a marked position-dependent subluxation (anterolisthesis)
at L3-4 and an accompanying spinal stenosis that were not
visible on the recumbent MRI.
The patient's Upright™ images
established that there was a genuine physical basis for her
symptoms, whereas her recumbent MRI images had failed to do
so. The new Upright™ images supplied her surgeon with
the necessary evidence that additional surgery was warranted
to correct her problem.
A spinal fusion was performed at L3-4
one month after the patient's Upright™ MRI scan. The
surgical outcome was positive. To date, almost four years
post-op, the patient remains symptom free and reported to
FONAR, "Thank you for giving me my life back."
* laminectomy and L45S1 fusion
Rose Radiology Centers