Radiculopathy, upright mri

Back pain and radiculopathy is common….very common. Furthermore, it is very common for patients to explain that it ‘hurts’ more when they are vertical. Then why are we mainly looking at supine MRI for findings? Supine MRI is helpful in ruling out pathology and does offer higher resolution with the 1.5 and 3.0 Tesla…but this magnet power is not necessary to investigate biomechanical problems.

In a recent research paper published in The Journal of Craniovertebral Junction and Spine [full text], these group of researchers looked at seventeen adults (10 asymptomatic and 7 symptomatic) and used the .6 Tesla MRI to evaluate the lumbar spine and pelvis in the seated position.

They looked at the “foramen area, height, mid-disc width, width, thickness of ligamentum flavum, disc (bulge, height, width), vertebral body (height and width), and alignment (lordosis angle, wedge angle, lumbosacral angle).” 1

Some of the important results showed significant foramen narrowing and disc bulge was 48% greater in symptomatic volunteers compared to asymptomatic volunteers. Thickness of ligamentum flavum increased as well.

Overall, the researchers were cautious in their conclusive remarks…like all great researchers. But the bottom line is that we all know that symptoms related to spine are often worse being vertical. It is a bit of a no-brainer to continue to investigate the tissue in its load bearing state.

Yet another reason why Dynamic Disc Designs knew it was inevitable that a dynamic model would be to market. They were the first to pioneer this patient education movement. Be sure you are equipped.

flexible spine model nerves


  1.  Nguyen HS, Doan N, Shabani S, Baisden J, Wolfl a C, Paskoff G, et al. Upright magnetic resonance imaging of the lumbar spine: Back pain and radiculopathy. J Craniovert Jun Spine 2016;7:31-7.

Microgravity causes increased swelling to the intervertebral discs of astronauts yielding back pain.

In a study published in the European Spine Journal, researchers looked to understand more clearly the relationship of why disc herniation is multiplied by a factor of four after spaceflight. These researchers looked at the swelling disc height changes as it related to annular strain and how this impacted nuclear pressure while bending forward.

Herniation, protrusion, modelEight human lumbar functional segmental motion units were tested using a free-swelling technique to simulate the microgravity environment.

What they found was that by hyperinflating the discs with saline, so did the pressures within the intervertebral discs. There was also a connection seen with increased annular stress in flexion and compression.

Furthermore, Law’s et al. showed a decrease in flexibility when the discs where hyperhydrated–something that we are understanding more and more now, as Michael Adams published some time ago.

Dynamic Disc Design’s Fully Clear Lumbar Disc Model, for example, is ideal for demonstrating this exact mechanism to patients.

With this model, complicated research can be quickly explained to the patient in helping them understand why morning stiffness leads to decreased flexibility as the disc is hyperhydrated.

Use a flexion disc model to educate patients.

Research like this, which is so important to relay to patients as it helps explain their symptoms, is not always easy to communicate. Dynamic Disc Designs works to simplify the complex, making it easier for you, the professional, to convey important concepts that are easy to understand. Patients that understand are more compliant and this process will inevitably lead to better clinical outcomes. And in turn, it is the outcome that ultimately determines a doctor’s income.

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Disc Height - Patient Education

Disc degeneration is thought by many to be at the root of back and neck pain.

However, measuring degeneration has always been a challenge because of its elusive nature. One characteristic of degeneration that all agree on is disc height, or in other words, the spacing between vertebra. It is one of the most looked for finding on MRI, x-ray and CT when evaluating for a patient’s pain.

In a recent research paper by Andrew J. Teichtahl et al. in Arthritis Research & Therapy (2015) 17:297 DOI 10.1186/s13075-015-0820-1, these researchers found a dose-response relationship between the severity of disc degeneration and lumbar disc height.

The authors believe that their study provides the first evidence that lumbar disc height is a reliable and easily accessible measure in the determinant of lumbar disc degeneration.

Lumbosacral disc degeneration is very common with as many as one third of individuals showing disc degeneration in this region when investigated with MRI. Furthermore, with degeneration, it increases the risk by two-fold in the development of chronic low back pain. With these facts at hand, it is imperative to measure disc degeneration but this is not as easy as thought because of the varying definitions. Disc degeneration can be a complex condition with characteristics of cell proliferation, nucleus pulposus dehydration, annular fissures and clefts, endplate disruption and granulation changes.

Radiographic evidence of disc degeneration can also demonstrate endplate sclerosis, osteophytosis and joint space narrowing (aka, disc height). The most recognized technique to evaluate the degree of disc degeneration is the Pfirrmann’s method which is endorsed as a valid and reliable method of assessing intervertebral disc degeneration using MRI.

These researchers looked at MRIs from 72 community based individuals and found that disc height was the best quantitative measure as an outcome measure in epidemiological studies.

Dynamic Disc Models enables spine doctors to share important clinical findings ,like disc height, to patients in a dynamic and interactive way, demonstrating facet shingling, intradiscal findings and disc herniation on a dynamic platform to improve education of pain generators. An educated patient often is more compliant as they understand more clearly the movements and activities that can exacerbate their symptoms like excessive spinal flexion and incorrect lifting.