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Related Experiment Video

Updated: Jul 13, 2026

3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache

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Published on: June 2, 2014

Imaging in the position that causes pain.

John W Gilbert¹, Greg R Wheeler, Richard A Lingreen

¹Spine and Brain Neurosurgical Center, Lexington, Kentucky 40503, USA. rebeccaq@sbncmd.com

Surgical Neurology

|August 21, 2007

Summary

Positional magnetic resonance imaging (MRI) of the cervical spine can improve diagnostic accuracy. Imaging in the symptomatic position reveals spinal protrusions missed by conventional MRI, leading to better treatment plans.

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Area of Science:

Neurosurgery
Radiology
Orthopedics

Background:

Conventional magnetic resonance imaging (MRI) is noninvasive and excels at soft tissue visualization.
Recumbent MRI may underestimate spinal conditions due to lack of physiological stress.
Symptomatic positioning during MRI can reveal pathologies not evident in neutral positions.

Observation:

A patient with neck and arm pain experienced paresthesias in C6 and C7 dermatomes.
Conservative treatments were ineffective.
Positional MRI, particularly with the head turned right, identified C5-C6 and C6-C7 protrusions.

Findings:

Cervical spine MRI performed in the symptomatic position (upright, extended, head turned right) clearly showed C5-C6 and C6-C7 protrusions.
These protrusions were not apparent on conventional neutral upright MRI.
A targeted epidural block at the affected levels provided pain relief and functional recovery.

Implications:

Positional MRI of the cervical spine can enhance diagnostic sensitivity and accuracy.
This technique may lead to more precise diagnoses and targeted treatment strategies for spinal conditions.
Positional MRI could potentially reduce the need for invasive procedures like myelography.