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The 65 year-old female patient has been suffering for many years from pain in the lumbar spine which has significantly worsened in the last two years. No side preference. No trauma. Pain extending into the ventral/ventrolateral thigh on both sides, right side much severer than left. Increase in pain when under pressure, particularly during sport.
A recently carried out conventional MRI examination while recumbent produced no clear statement as to the cause of the pain symptomatology. Subsequently, functional imaging was carried out in the Upright™ MRI of the patient sitting upright.

Functional Imaging in the natural weight-bearing state
Sagittal in flexion, sagittal neutral, sagittal in hyperxtension, coronal.
By means of the Upright™ MRI examination performed in a natural weight-bearing state, particularly under functional imaging, the spondylolisthesis could be clearly pictured and unequivocally proven.
In a conventional MRI examination in a recumbent position in a tube a spondylolisthesis would not be visible.

The diagnosis:

Using the Upright™ MRI examination, upright in the natural weight-bearing state, a ventral displacement of the vertebral body L4 opposite L5 could be proven.

At the junction in flexion there is an increasing anterolisthesis visible at  L4/5 with a decrease in the venrodorsal diameter of the spinal canal at this level.

In the upright position flat intervertebral disc protrusions at the levels L2/3 and L3/4 are visible.   In the coronar section a left convex lateral malposition of the lumbar spine is clearly depicted.

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