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|Clinical Cases - FONAR Upright™ MRI | Case study #4
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The patient is a 64 year-old male who has suffered for many years from pain in the area of the lumbar spine. 1 ½ years ago an operation was carried out on the spinal column at L4-L5 and a so-called X-Stop implant was successfully inserted which resulted in freedom from pain.

Now the patient is complaining once again of pains in the lumbar spine region, spreading to the buttocks and both thighs.  Whilst lying down, pain does not occur, however while standing and sitting there is a clear increase in pain in hyperextension and pain relief in flexion. 

The patient was examined in the Upright™ MRI, both recumbent and sitting upright, in hyperextension and in flexion.

Functional Imaging in the natural weight-bearing state
Sagittal inages, sitting in flexion, neutral, hyperextension and recumbent.

The diagnosis :

Constitutionally longer stretch relative osseous stenosis of the spinal canal from L1-S1. Significant additional restrictions  of the spinal canal at L2-L3 through disc protrusions. Slight decrease in vertebral canal stenosis in flexion, significant decrease in supine position. In hyperextension distinct pincer-shaped spinal stenosis at L2-L3 and L3-L4. At L4-L5 postoperatively nothing but implied spinal canal stenosis.

The MRI findings are compatible with a pseudo-radicular symptomatology as well as an intermittently occurrring intradural nerve entrapment syndrome dependent on the position.

Axial image at L3-L4 disc protrusion with significant constriction of the spinal canal and impression of the dural sack.
Axial image at L4-L5 bulging of the spina lcanal through the X-Stop implant in all positions.
This case history was kindly placed at our disposal by Prof. Dr. med. Hans-Konrad Beyer of the Private Practice for Upright™ Magnetic Resonance Imaging Cologne/Germany. You can reach the site at www.mrt-koeln.de