Upright MRI shows pathology that you can not see in a lay down MRI. 111 patients showed no pathology in a lay down MRI.47 of these patients showed pathology in an Upright MRI. AMA Guidelines state that maximum pathology of the spine can be…

1. Your Nomination - Please briefly describe in your own words the question about a health care test or treatment that interests or concerns you:: Upright MRI shows pathology that you can not see in a lay down MRI. 111 patients showed no pathology in a lay down MRI.47 of these patients showed pathology in an Upright MRI. AMA Guidelines state that maximum pathology of the spine can be seen with flexion and extension. UCLA School of Medicine found that 35% more pathology is seen of L4 and L5 of the spine with flexion and extension. Only the Upright MRI can show maximum pathology by the ability for the patient to be scanned in extension and flexion,lateral bending,weight bearing studies and scanning in a position of pain.The lay down MRI fails to convey to the surgeon information that is critical for the correct evaluation of the patients symptoms. The Upright MRI with a better correlation between patient images and patients symptoms helps improve surgical outcomes.

2. Why do you think your question is important? (you may select more than one category if appropriate): My question relates to a very common disease or problem
People with this disease or problem have considerable health or financial hardships
There is uncertainty about how well the test, treatment, or intervention works
There is significant potential for side effects/harms using this test, treatment, or intervention
Funding of this test, treatment, or intervention is uncertain or variable
There is unequal access or application of this health care intervention across providers
There is potential for cost savings from better information on this subject
This is a new technology/development
There is new evidence of clinical and/or cost effectiveness for this test, treatment, or intervention
Other

3. What illness or health condition is related to your question? (You can also specify a particular health-promoting activity, such as breast-feeding): Upright MRI has many applications. It is dramatically effective for Spinal pain and Scoliosis, to eliminate x-ray radiation exposure that causes cancer.

4. What group(s) or patients does your question apply to?: Anyone with spinal pain.It is expected that by the year 2012 over 1 million spinal surgeries will be performed each year. As the population ages more individuals will have spinal pain and physical problems.

5. What is the specific purpose of the health care test or treatment you have a question about? (mark all that you think apply): Identification of a disease or condition:
Screening or diagnosis/identification for a particular disease, or risk assessment for a disease
Risks or harms that can come from a disease identification tool or test
Diagnostic tests and tools
Diagnosis of co-occurring diseases
Intervention (such as a drug treatment, therapy, device)
Management of a condition or particular system of care
Delivery of a health service
Referral
Risks or harms associated with treatment of a disease or condition
Prevention or health promotion
Specific population health concerns, such as ethnic group or gender
Other
Dont know

6. Does your question include a comparison of different health care approaches?: Yes
If yes, please list what you would like to see compared:
Lay down MRI versus Upright MRI.

7. Desired Health Improvements: If you question focuses on:: Identification of a particular disease or condition, what improvements in identification or diagnosis would you like to see?
Seeing more spinal pathology to improve spinal surgical outcomes and elimination of x-ray radiation for Scoliosis patients.

Treatment of a particular disease or condition, what improvements in patient symptoms or problems would you like to see? Improved surgical outcomes. Eliminate radiation exposure.

8. Harms: Are there risks, side effects, or harms you are concerned about? If yes, please specify what those are:: Not seeing complete pathology of the spine leads to failed spinal surgery. 26% of spinal surgeries are not successful.

9. Based on your answers to the previous questions, what research question(s) would you like to have answered?: AMA Guidelines to Impairment 5th Edition Page 372 indicates that maximum pathology of the spine is seen in flexion and extension. There are no specfic CPT codes for this when it comes to MRI scans. How effective is Upright MRI versus Laydown MRI? If you see more pathology,will you see improved surgical outcomes?

10. Are there health-care focused, disease-focused, or patient-focused organizations that you see as being relevant to this issue? Who do you think we should contact as we consider your nomination?

11. Other Information About You (OPTIONAL) In order to help us understand the context of your health care question, it would be helpful to know more about you. The answers you give will not influence the progress of your suggestion. Thank you.: a. Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)
Health Care industry (device)

b. Is there any other information about you that is relevant to your question?
Surgeons who know about the Upright MRI have no use for the lay down

c. Are you making a suggestion as an individual or on behalf of an organization?
Individual
Organization

Effective Health Care Program