Disc Protrusion, Pain, sitting, back pain, upright MRI

Disc protrusion is defined by an extension of nuclear material extending beyond the confines of the annulus (if the base of the material is larger than the material protruding). In the flexed position, the nucleus pulposus is driven backwards (posteriorly) into the spinal canal. If there are nerves in the area, related pains can extend down into the leg (or legs) causing sciatica.

MRI is our powertool for looking at disc injuries. It was developed in the early 1980s and primarily used to look for pathological conditions like cancer. And because it was and still is important to keep the patient still, lying down (recumbent) MRI was the standard.

However, when looking for load related pain, lying a patient down is not always the best strategy as often a patient’s symptoms disappear when they are on their backs. So it would seem reasonable to image patients in a vertical or upright position to look closely at the tissues as they are loaded….this only makes sense.

Here is an example of how the diagnosis was seen when the spine was placed in the seated position. This patient only had symptoms while sitting. And you can see why below.

Disc Protrusion with Upright MRI

Standing, Case, Modeling, MRI, Upright

Pain, sitting, back pain, upright MRI

In this case, the patient demonstrates further protrusion with sitting…and the upright MRI clearly shows this difference from standing to sitting. This is why it is important to consider upright MRI when the patient presents with a load dependent complaint. Upright MRI can help with the diagnosis.

All MRI images on this page are property of Medserena Upright MRI Centre.

Dynamic Imaging, Professional LxH Model

Dynamic Imaging Important – Dynamic Spine Models to Match Ongoing Findings

Upright MRI dynamic imaging entered the scene in the 2000’s. Since then, controversy of its value has been under fire. Some believe that the .6 Tesla power of the FONAR MRI does not provide images of the same resolution as the conventional 1.5 Tesla recumbent MRI. However, mounting evidence is starting to take shape and it is difficult to argue how the upright MRI is not important when looking at patients in a weight bearing mode–and finding spondylolisthesis otherwise undetected.

Medserena Upright MRI Centre is one of those leading facilities that continues to reveal spinal findings that often go undetected by conventional lie down MRI. In a recent case study, a 74 year old lady that underwent a laminectomy surgery 7 years ago was unable to walk without pain.

After a work-up by the team they looked at imaging the spine in a vertical fashion–compared to conventional lying down. This is what they found.

Conventional Imaging Supine

Conventional Supine Imaging

And when the patient was imaged in a seated position, this is what they saw–a slippage of L4 on L5:

Sitting MRI

Sitting Neutral

And when the patient bent backwards while sitting, stenosis was revealed. You can see the hourglass narrowing.

Sitting extension, stenosis

Sitting Extension

This is an example of how dynamic MRI imaging can play a crucial role in determining a patient’s problems. This revealed problem can now be diagnostic to help guide the treatment plan whether through conservation means or surgical intervention.

Dynamic Disc Designs develops models with load in mind through careful construction of a dynamic annulus and nucleus. To have a model to explain and demonstrate these kinds of pathologies is very helpful to both clinicians and patients. Our list of spondylolisthesis models is just one example how Dynamic Disc Designs is working to make a clinical difference through education. Furthermore, our Lumbar Spinal Stenosis Model demonstrates narrowing in extension as the ligamentum flavuum buckles onto itself.

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All MRI images on this page are property of Medserena Upright MRI Centre.