Spondylolisthesis
shown to require additional fusion segment once its degree of instability,
not visible by recumbent-only MRI, was demonstrated by Fonar Upright
MRI.
Clinical Case Overview
The patient was a 49-year-old male who had had a 20-year history
of chronic back pain and a three-year history of right lower extremity
radiculopathy.
Prior to the Upright™ scan, the patient was scanned in a
recumbent-only MRI (1.5T). It showed a right paracentral disk herniation
at L5-S1. Based on the recumbent images, neurosurgeon Bennie W.
Chiles III, M.D., said:
![Neutral-Sit](images/chiles1_neut.jpg) |
![Flexion](images/chiles1_flex.jpg) |
![Extension](images/chiles1_ext.jpg) |
Neutral-Sit |
Flexion |
Extension |
“I would have likely performed a diskectomy at L5-S1 to relieve
pressure on the nerve root, along with an L5-S1 fusion for the back
pain. Fusing L4-5 was not an initial consideration because no spinal
instability was seen on the recumbent MRI.
When the dynamic flexion and extension images performed
in the Upright™ MRI demonstrated an instability at L4-5 and
showed the full extent of that instability once the patient’s
body weight was applied, I chose to also fuse L4-5 during the procedure
rather than treat L5-S1 alone.
The result was a better outcome for the patient whose severe right
leg pain is now gone and whose back pain is much reduced.”
![Bennie W. Chiles III, M.D., F.A.C.S.](images/chiles.jpg)
Bennie W.
Chiles III, M.D., F.A.C.S.
Westchester Spine and Brain Surgery, PLLC
Hartsdale, New York,
Upright Imaging of Westchester, P.C.
Yonkers, New York
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