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Clinical Rationale
Axial Loading during MR Imaging Can Influence Treatment Decision for Symptomatic Spinal Stenosis
Akio Hiwatashi, Barbro Danielson, Toshio Moritani, Rober S. Bakos, Thomas G. Rodenhause, Webster H. Pilcher and Per-Lennart Westesson, American Journal of Neuroradiology 25:170-174, February 2004.
Three experienced neurosurgeons reviewed non-axially loaded MRI images of 20 patients with narrowing of the spinal canal and then subsequently reviewed axially loaded MRI images of those same 20 patients.
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All three neurosurgeons changed their treatment decisions from conservative management to decompressive surgery for 5 of the 20 patients;
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Two of the three neurosurgeons changed their treatment decisions for 7 of the 20 patients;
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One of the three neurosurgeons changed his treatment decision for 11 of the 20 patients.
Independent studies show the value of axially loaded diagnostic imaging.
Three experienced neurosurgeons reviewed non-axially loaded MRI images of 20 patients with narrowing of the spinal canal and then subsequently reviewed axially loaded MRI images of those same 20 patients.
-
All three neurosurgeons changed their treatment decisions from conservative management to
decompressive surgery for 5 of the 20 patients; -
Two of the three neurosurgeons changed their treatment decisions for 7 of the 20 patients;
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One of the three neurosurgeons changed his treatment decision for 11 of the 20 patients.
Without Axial Loading
With Axial Loading
Only Feeling pain while standing?
Weight-bearing MRI, also known as Axial-loaded MRI, simulates a standing up position by applying compression to the lumbar spine. The imaging captures how the patient actually feels while standing, and takes into account the effect that gravity has on a patient’s spine. Portal Gravity system applies 50% of the patient’s body weight in compression. This closes the gaps in the L-spine thereby revealing herniation and bulges that did not present as significantly when the patient was in a relaxed position. Adding 50% compression does not create false positives of medical conditions that do not exist.