Scientific
Paper presented at the
European Society of Skeletal Radiology (ESSR)
Oxford, England, July 2005
Positional, Upright MRI
Imaging of the Lumbar Spine
Modifies the Management of Low Back Pain and Sciatica
F.W. Smith, M.D., M.
Siddiqui, University of Aberdeen, Scotland
--------------------------------------------------------------------------------
With the ability to image the lumbar
spine using MRI in the Upright position, comes the question;
Does this method of spinal imaging influence patient management?
Twenty-five
patients referred for MRI of the lumbar spine 1 following
at least one prior, “normal” MRI examination within
six months of referral have been reviewed. 14 men and
12 women aged between 38 and 67 years of age were scanned
using a 0.6T “Upright” MRI Scanner (FONAR New
York). Each patient was scanned supine, standing erect and
in the seated position. In the seated position images were
made with the back in neutral, flexed and extended. Thus a
series of five different positions were available for scrutiny.
Sagittal T2 and Axial T2 weighted sections were made through
the lower five intervertebral discs in each position.
In twelve cases, no significant abnormality
was seen in any of the five postures. In
thirteen, abnormalities were demonstrated in one or more of
the seated postures that were not evident in the conventional
supine examination. In three cases lateral disc herniation
was only seen in the seated position. In six cases the presence
of a hypermobile disc at one or more levels was demonstrated.
In two cases previously unsuspected grade 1 spondylolisthesis
was shown and in two cases significant spinal canal stenosis
was seen in the seated extended position.
In 50% 2
of these cases that had previously been investigated for sciatica,
a surgically remediable lesion was found. Each of the
thirteen patients has undergone appropriate surgery and six
months post surgery remain symptom free.
1. (for sciatica)
2. (52%,
13/25)
Source: http://www.essr.org/downloads/Scientific%20Presentations.pdf
(pages 75-76)
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