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). The patient 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 an exhausting and painful situation, and can aggravate the symptoms.
The Upright MRI has many advantages. First, it can show load-dependent issues. Second, instabilities that would have been missed or looked less severe in a prone and stress-free position might be detected via Upright MRI. Last, a myelon compression that only occurs with movement of the head might only show up on upright imaging.
MRIs do not have any radiation, and they show bones and soft tissue as well. MRIs allow to directly evaluate capsules and ligaments of the cervical spine.
However, there are disadvantages too. Upright MR images do not have a high resolution, and, unfortunately, the costs are not carried by German insurance companies. Additionally, many doctors do not accept those images, or have no idea how to read them. However, more doctors than in the past include Upright MRIs in their examinations.
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.