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,
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)