Pushing the Limits of the Prone Position in the Intraoperative Magnetic Resonance Suite

Patient positioning is an integral part of surgical planning, and numerous variations have been suggested to optimize the prone position. So far, however, little attention has been given to address the restrictions and special needs in an intraoperative MRI suite.

To share our experience of transforming the modified prone position from the conventional operating room to the intraoperative MRI suite.

Two-room 3T intraoperative MRI suite. Detailed description of the technical pearls is provided.

Ten procedures in 9 consecutive patients (2 female and 7 male) were performed. The median age was 8 years ranging from 4 to 71 years. We experienced no complication from patient positioning. Neither size (range 104-182 cm) nor weight (range 18-98 kg) of the patients was a limiting factor. In none of them, the surgeon experienced an adverse event from inadequate patient positioning and the surgical goals could be achieved without restrictions. An intraoperative MRI could be acquired in all of them with the same image quality as observed for standard positions.

A transition of the modified prone position from the conventional operating room to the intraoperative MRI suite is feasible, if some crucial steps are considered. We provide a detailed technical description that could be used as a guide by others.