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
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.