Simulating the Upright Position During Recumbent Diagnostic Imaging
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Conventional MRI and CT exams scan patients in the recumbent position thus negating the effects of gravity on the spine. The Portal Gravity System* which is 510(k) FDA approved and compatible with all commercially available standard MRI and CT systems, places an axial load on the spine during routine imaging procedures. This simulates the upright position providing additional valuable information and may reveal occult pathology and shows the true severity of the problem.
• Better Diagnostic Results • Competitive Edge • Increase Referrals • Easy-To-Use
Additional valuable information obtained with the PGS ensures more certainty in diagnostic and treatment decisions.
Multiple sizes of vests make it quick and easy to connect the patient to the PGS. *US and Foreign Patents Pending
Custom made springs maintain constant axial load during study.
Load sensors that are integrated into the footplate measure the amount of force being applied and are accurate to within 1/10th of a pound.
CLINICAL RATIONALE
CLINICAL RATIONALE Independent studies show the value of axially loaded diagnostic imaging.
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With Axial Load
Axial Loading During MR Imaging Can Influence Treatment Decision for Symptomatic Spinal Stenosis, Akio Hiwatashi, Barbro Danielson, Toshio Moritani, Robert 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. • All three neurosurgeons changed their treatment decisions from conservative management to decompressive surgery for 5 of the 20 patients; • Two of the three neursurgeons changed their treatment decisions for 7 of the 20 patients; • One of the three neurosurgeons changed his treatment decision for 11 of the 20 patients.
CASE SAMPLES Without Axial Load
Without Axial Load
With Axial Load
With Axial Load
Images courtesy of Yair Safriel, M.D.
Images courtesy of Yair Safriel, M.D.
CLINICAL
RATIONALE
Without Axial Load
Without Axial Load
With Axial Load
With Axial Load
Dynamic Effects on the Lumbar Spinal Canal: Axially Loaded CT-Myelography and MRI in Patients With Sciatica and/ or Neurogenic Claudication, Jan Willén, M.D., Ph.D.; Barbro Danielson, M.D., Ph.D; Arne Gaulitz, M.D.; Thomas Niklason; Nils Schönström, M.D., Ph.D; Tommy Hansson, M.D., Ph.D, SPINE 1997, Volume 22, Number 24, pp 296876. •
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79% of patients experienced a significant reduction of the dural sac cross-sectional area during axial compression; 35% of patients passed the borderlines for relative (100mm2) or absolute stenosis (75mm2); 36% of patients experienced deformation of the dural sac during axial compression; 13% of patients experienced a narrowing of the lateral recess during axial compression.
This study recommends axial loading of the lumbar spine in computed tomographic scanning and magnetic resonance imaging and concludes that the diagnostic specificity of spinal stenosis will increase considerably when a patient is subject to axial load.
Images courtesy of Yair Safriel, M.D.
Study Presented at the 2002 American Society of Nueroradiology (ASNR) 40th Annual Meeting and Symposium. Presented by S. Kahn, J.F. Hemmer, W.K. Earley, J.F. Seeger of the University of Arizona Health Science Center.
Without Axial Load
With Axial Load
Images courtesy of Yair Safriel, M.D.
Without Axial Load
• 33% of the patients examined progressed from a non-critical to critical stenosis of the thecal sac with axial loading; • There was an AP diameter reduction in 50% of levels in sagittal scans and a cross-sectional area reduction in 64% of axial scans at all disc levels imaged; • 25% of patients with one critical stenotic level developed a second critically stenotic level under axial loading; • Previously undetected synovial cysts of diverticulae developed at 20 levels during axial loading of 50 patients.
With Axial Load