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)