Purpose: A conventional magnetic resonance imaging (MRI) was conducted in supine position, showing a slight different from that conducted in upright position. Therefore, we simulated the upright position by applying the axial load on a lumbar spinal stenosis patient and measured the change of neural tube size in axial load and standardized the data. Materials and Methods: We compared the axial loading MRI obtained from spinal stenosis patients who visited Wonkwang University Hospital outpatient

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... clinic between October 2010 and May 2011 showing radiologic and physical symptoms. Results: Neural tube sizes by conventional MRI were as follows: 195.57 mm 2 and 203.20 mm 2 on average between the left and right sides in L3/4; 194.64 mm 2 and 211.43 mm 2 on average in L4/5; and 199.38 mm 2 and 203.04 mm 2 on average in L5/S1. Neural tube sizes by axial loading MRI were as follows: 166.43 mm 2 and 174.27 mm 2 on average between the left and right sides in L3/4; 154.81 mm 2 and 158.67 mm 2 on average in L4/5; and 148.48 mm 2 and 157.19 mm 2 on average in L5/S1. Changes of neural tube sizes in L3/4, L4/5, and L5/S1 had a significant correlation (p<0.05). Conclusion: The axial loading device was an excellent tool in simulating the upright position for spinal stenosis patients, and the change of neural tube sizes reproduced for the upright position was statistically significant. This is thought to be meaningful for clinical applicability.