With the advent of magnetic resonance imaging (MRI), imaging capabilities for low-back pain patients have been markedly expanded to include identification of spinal abnormalities such as tumors, infections, and degenerative problems in a noninvasive fashion. The pitfall of MRI, as well as computed tomography (CT), however, is that they are both performed with the patient lying supne with the spine unloaded. For many patients, this is the position tgat helps to relieve symptoms, and thus it may not be possible to identify accurately the pathology causing pain when the patient is standing or in motion. Although many feel that myelography is an outdated procedure, it does have the advantage of being able to provide images of the patients standing and in flexion-extension. One of the authors (SHH) suggested that flexion-extension MRI scanning of the lumbar spine be attempted in order to simulate real-life motion. Because of the small bore of the MRI scanner, this could only be accomplished with very small, thin subjects. However the same process was later applied to the cervical spine. This resulted in a noninvasive method allowing cineradiographic visualization of pathology with the cervical spine in various positions ranging from flexion to extension.
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