Using Upright Cervical MRI to Diagnose Craniocervical Instability

Whether it’s because of headaches, neck pain, neurological issues, or a combination of symptoms, those with craniocervical instability (CCI) can wind up with endless challenges just trying to make it through the day. 

Getting an accurate diagnosis for CCI can be tricky, but it’s vital for effective treatment and management of your condition. One of the best tools to properly diagnose CCI is upright cervical magnetic resonance imaging (MRI). 

Today, we’ll take a look at how this test works, the benefits and advantages of upright MRI versus traditional imaging methods, why neurosurgeons prefer this technique when diagnosing CCI, and the importance of rehabilitation after diagnosis. Let’s get started! 

Upright Cervical MRI: What You Need to Know

Upright cervical MRIs play a key role when it comes to diagnosing CCI. Put simply, an upright cervical MRI is a type of MRI that allows you to be scanned while sitting or standing, rather than the standard supine (lying down) MRI that’s performed for most conditions. 

The reason an upright MRI is done is because it’s easier to see how your spine and surrounding structures behave under normal circumstances - under gravity - when you’re in a sitting or standing position, which makes all the difference when diagnosing conditions like CCI. 

Key Benefits of Upright Cervical MRI

Here are some of key advantages of the upright cervical MRI:

• Weight-Bearing Imaging

Traditional supine MRIs and CT scans tend to miss issues that only appear when your body is in its natural, weight-bearing position. Upright MRIs show how the weight of your head under gravity can compromise the stability of your neck, making it a vital tool for diagnosing conditions like CCI. 

Upright cervical MRIs also show how your ligaments and other structures in your neck behave when under normal stress, such as the normal force of gravity. These scans allow for a valuable, more comprehensive view of possible injuries. 

• Dynamic Imaging

Upright MRI can be done while your neck is in various positions, like extension (bending backward), flexion (forward bending), or rotation (turning to the sides). Instability is often more apparent for those with CCI when their neck is in motion, making the dynamic aspect of upright MRIs especially helpful for diagnosis. 

Observing the way your neck moves and understanding what positions it may be unstable in allows your doctor to get a thorough picture of your condition.   

• Better Diagnostic Accuracy

Ligament injuries may be missed during a scan where you lie flat. Upright MRIs are effective at detecting ligament injuries and giving your doctor necessary information that helps them identify misalignments or instability that may be adding to your symptoms. 

The detailed images of your neck and craniocervical junction that upright MRIs capture are particularly helpful for spotting abnormalities. Issues such as ligament laxity, misalignments, or structural problems that contribute to CCI can go undetected on other scans. 

Diagnosing More than CCI

Some conditions are difficult to spot and diagnose with traditional imaging. If you’re in pain or trying to navigate life with challenging symptoms, it can be upsetting to be left without answers and no closer to the relief you need.

In addition to identifying CCI, diagnosing conditions such as joint hypermobility, EDS, and POTS can be easier with the dynamic images provided by an upright MRI. Precise diagnosis is necessary for managing symptoms of these conditions, and the upright MRI can give detailed information needed to help develop the best treatment plan for you. 

Upright cervical MRIs provide the dynamic view and detailed images of weight-bearing structures that doctors need to properly diagnose craniocervical instability. Getting an accurate diagnosis is the first step toward managing your CCI. Once you discover the root cause of your symptoms, you can work with a professional to make an informed decision about the best treatment plan for you.

The Preferred Method of Neurosurgeons

Because upright MRIs provide a more accurate picture of your spine and surrounding structures under natural, weight-bearing conditions, it’s often preferred by neurosurgeons for diagnosing craniocervical instability. 

Here are a few more details on why neurosurgeons often choose upright MRIs over traditional imaging methods to diagnose conditions like CCI: 

• Natural Positioning

Upright cervical MRIs give information on the real positions your neck is in throughout the day. Seeing your neck under normal, everyday stress conditions gives a more accurate representation of the problem area, whereas lying down, these misalignments and structural problems may not be visible. 

• Dynamic Images

Understanding how your cervical spine moves and where it may be unstable is key for a proper CCI diagnosis. Upright MRIs offer dynamic images of your neck in various positions, which gives your doctor a comprehensive look at your condition and allows them to determine the best path forward. 

• Improved Patient Outcomes

A clear understanding of the underlying issue allows for a targeted and more effective treatment plan. Starting out with the most accurate information means your path to treatment will be better informed and ultimately lead to better outcomes. 

While upright cervical MRIs have many benefits, some neurosurgeons have reservations. Traditional MRIs or CT scans, where you lie flat, may have slightly better image quality compared to upright MRIs. This is because the magnets used in upright MRIs can be less powerful and produce lower resolution images. 

Despite the potential drawbacks of slightly lower image quality, the benefits of seeing dynamic images of your spine in normal, weight-bearing positions can lead to more accurate diagnosis, often outweighing the compromise in image resolution. 

The ability to develop effective treatment plans based on accurate diagnoses is worth the potential trade-off in image clarity, and keeps upright MRIs as the top choice among neurosurgeons for diagnosing CCI and similar conditions.

Rehabilitation Post-Diagnosis

Early intervention for CCI is essential to limit progression and optimize your health, so it’s important to start working with a specialist as soon as you’ve been diagnosed with craniocervical instability.

At ActifyPT, our care plans are designed based on each patient’s individual needs. This means your treatment will be tailored to address the root cause of your problems, fit into your lifestyle, and designed in a way that will help you reach your goals, setting you up for success from day one. 

Our clinicians specialize in treating conditions like CCI, joint hypermobility, Ehlers-Danlos Syndromes, and Postural Orthostatic Tachycardia Syndrome. We understand the unique challenges you face every day, and have the specialized training necessary to help manage your condition. 

Managing CCI and living an active life that you love is within reach when you have the right support. If you’re experiencing symptoms of CCI or similar conditions, don’t wait to connect with us. Our experts at ActifyPT are ready to help you get the relief you need!

Key Takeaways

Upright cervical MRIs are performed in a standing or sitting position, rather than standard supine MRIs. 

• Upright cervical MRIs show how the spine behaves in a natural position, while influenced by gravity. This allows for a more accurate look at the underlying issue. 

• The weight-bearing position of upright MRIs combined with dynamic imaging can reveal problems that supine MRIs might miss, like ligament injuries. 

• Although image resolution may be slightly reduced, neurosurgeons often prefer upright MRIs for their ability to show the spine behaving in natural positions.