Upright MRI is a form of magnetic resonance imaging which allows to take images of the patient in a weight bearing position (sitting or standing) between two magnetic shields. The patients does not have to be in a small tube and is not in a prone position.
The Upright MRI of the cervical spine takes place in a sitting position.
In the beginning the cervical spine is in neutral position.
Then images in maximum flexion and extension are taken to evaluate the whole cervical spine.
To evaluate the upper cervical spine and the cranio-cervical junction an examination in rotation as well as in maximum lateral bending can be performed additionally.
The head has to be in each position for a couple of minutes and is fixed in that position to protect from movement. That may be a exhausting and painful and can aggravate the symptoms.
The Upright MRI has the advantages that it can show load dependent issues. Moreover instabilities can be missed or look less severe in a prone and stress-free position. Also a myelon compression which only occurs with movement of the head can only be shown in an Upright MRI.
For all MRIs there is no radiation exposure and they show bones and soft tissue as well. MRIs allow to directly evaluate capsules and ligaments of the cervical spine.
The disadvantages are that Upright MRIs do not have a very high solution and unfortunately the costs are not carried by german insurance companies.
However more doctors then in the past include Upright images in their examinations.
Upright MRI image lateral bending
Upright MRI image rotation
Upright MRI image extension
Upright MRI image flexion
Jinkins JR, Dworkin JS, Damadian RV. Upright, weight-bearing, dynamic–kinetic MRI of the spine: initial results. European radiology. 2005 Sep 1;15(9):1815-25.