Open stand-up MRI: a new instrument for positional neuroimaging

Area of Science:

• Neurosurgery
• Radiology
• Orthopedics

Background:

• Conventional recumbent magnetic resonance imaging (MRI) may fail to identify symptomatic cervical disc pathologies.
• Accurate diagnosis is crucial for effective treatment of cervical radiculopathy.

Observation:

• A 40-year-old male presented with refractory neck and left arm pain, paresthesias, and numbness.
• Standard supine MRI showed a C5-C6 disc protrusion, which did not correlate with symptoms.
• Upright, weight-bearing MRI with extension revealed a C6-C7 disc protrusion causing neural foraminal stenosis.

Findings:

• Positional cervical disc protrusion at C6-C7 was identified using weight-bearing MRI with extension.
• This positional finding correlated with the patient's neurological symptoms and C7 nerve root distribution.
• The diagnostic accuracy was improved by imaging in a weight-bearing, symptomatic position.

Implications:

• Imaging the spine in a weight-bearing, extended, or pain-inducing position can improve diagnostic yield.
• This approach offers valuable information for neuroradiologists and neurosurgeons.
• Enhanced diagnostic information can lead to more targeted treatments and improved patient care for spinal disorders.