FIG 2. Routine and axially loaded MR images of a 56-year-old man with bilateral sciatica and claudication. All three neurosurgeons changed the treatment decision from conservative therapy to decompression surgery for this patient based on the additional information provided by the axially loaded MR images.

A, Routine T2-weighted image obtained at L4–L5 shows mild spinal stenosis.

B, Axially loaded T2-weighted image obtained at L4–L5 shows severe spinal stenosis, deformation of dural sac and bilateral lateral recesses, and prominence of the dorsal fat pad.