Weight-bearing MRIs promise to revolutionize chiropractic care. Find out
if this non-traditional alternative is right for your patients.
By Jennifer LeClaire
X-Rays revolutionized chiropractic and magnetic resonance imaging (MRI) took
diagnosis to a new level. Now next-generation MRI equipment is giving chiropractors
never-before-seen views of the underlying problem.
The technology is called weight-bearing MRI, or “standing MRI.”
Chiropractors are heralding the invention as a major breakthrough that will
lead to a greater understanding and appreciation of spinal and musculoskeletal
dynamics.
“Weight-bearing MRI uses traditional MRI technology in the mid-range intensity
level combined with a system design that allows for the efficient evaluation
of regions of the body under the influences of gravity and in the positions
that yield pain and dysfunction,” says Dr. Sana Khan, a principal of TrueMRI,
a medical imaging group based in Anaheim, Calif.
Comparing Apples with Oranges
As Khan mentioned, standing MRI uses traditional MRI technology. It’s
the application of that technology that chiropractors are calling groundbreaking.
Instead of lying down in an enclosed tube, standing MRIs allow patients to simply
walk in, sit down—or stand up—and be scanned.
Melville, New York-based MRI developer and manufacturer Fonar is behind the
system design. TrueMRI developed proprietary anatomical software for detailed
interpretation and biomechanical analysis. Combined, these technologies are
shedding new light on painful patient problems.
Prior to the development of standing MRI technology all MRI studies were completed
with the patient in the recumbent position. While recumbent MRIs are a proven
tool to reveal musculoskeletal disease, traditional scanners are limited by
the non-weight bearing position, which often does not expose the pathology that
causes the pain.
Standing MRIs allow chiropractors to see the consequences of real-world situations
on patients. The option of scanning patients in flexion, extension, rotation
and lateral bending allows radiologists to image patients in the exact position
that elicits symptoms. It also allows more patient comfort. There’s nothing
in front of the patient’s face, except maybe a baseball game on a TV monitor
straight ahead. That means no more concerns about claustrophobic patients.
“The only variation in a traditional MRI is what part of the body is being
scanned in horizontal position,” says Gerald Clum, DC, president of Life
Chiropractic College West. Fonar has made the technology available at the college
through a partnership between Life West and TrueMRI.
“If a patient is in pain or has the presence of symptoms when they are
standing, then weight-bearing MRI allows you to scan the patient leaning left
or leaning forward or leaning backwards or leaning sideways. You don’t
have that capacity with a traditional MRI.”
Prescribing the Standing MRI
Standing MRIs are gaining popularity, but they are not on every street corner.
With a price tag of about $3-5 million, there are a relative few around the
country and it’s likely that patients in less populated areas would have
to fly to an imaging center to have the standing MRI completed. The cost of
the actual scan, however, is comparable to a traditional MRI.
“You might be asking ‘Which of my patients would be a candidate
for a weight-bearing MRI scan?’ Simply stated anyone you would refer for
an MRI would be better off, as would you be, with a weight-bearing MRI,”
Clum says. “In particular those patients that have previously been referred
for an MRI that showed no meaningful findings and about whom you continue to
believe there is pathology present are prime candidates for a follow-up True
MRI study.”
Matt Sabrkhani, director of operations for TrueMRI, says he has documented evidence
of patients who have had several recumbent MRIs over a period of time that show
a one- to two-millimeter disk bulge. “When we do a weight-bearing MRI
on that same patient we find that the bulge is actually nine or 10 millimeters,”
he says. “The difference is scanning the patient in their position of
pain to find out what’s really going on.”
More Accurate Chiropractic
Clum says imaging patients in during the activities of their daily lives—in
the processes that are related to their suffering—yields a treasure trove
of previously unavailable clinical information.
“The applications of this technology for the Doctor of Chiropractic are
limitless,” Clum says. “The documentation of the findings we have
known were there but could never demonstrate is now available to us. Think about
the research possibilities that are now at our fingertips with the advent of
this technology!”
Stephen Below, D.C., founder of Below Chiropractic Clinic in Clanton, Ala.,
agrees that the potential impact of standing MRI technology is enormous in the
chiropractic field and beyond: “Standing MRIs are revealing dramatically
different results and substantially more information about the state of the
spine and soft tissue because of the gravity component.”
Will standing MRI technology replace recumbent scans, then? Experts say no.
Standing MRI technology compliments traditional scans. Traditional MRIs have
their place and value for many applications, like cardiac patients and brain
scans. But standing MRI technology is finding a place of prominence for patients
with spinal and musculoskeletal challenges where moving body parts aren’t
moving well or pain-free because the results of these scans allow chiropractors
to provide more targeted treatment.
Provide your feedback on this
article.
© Copyright 2005 Today's Chiropractic