Many spinal complaints present themselves in a load dependent fashion when patients explain the timing and positional onset of their pain. With stenosis, for example, symptoms of back and leg pain often present in the upright position and are relieved with recumbency or sitting. On the other hand we have conditions, like disc herniation, that are not conducive to sitting as sitting generates more spinal flexion and intradiscal pressures.
Recumbent MRI imaging has been the gold standard imaging for spine. But with the introduction of upright MRI, we are now seeing clinical differences in the spine when the spine is imaged in a load dependent fashion. An important study was conducted by Alyas F et al. titled : Upright positional MRI of the lumbar spine. They demonstrated that upright MR imaging is an important consideration if symptoms continue to present in the absence of significant findings on recumbent MRI.
Dynamic Disc Designs Corp. manufactures models to help show the potential differences seen between recumbent vs. upright MR imaging. A dynamic disc allows the user to show dynamic disc height changes and listhesis with a thickening ligamentum flavum in the discovery of spinal stenosis and other spinal conditions.
Share Now
