Rare upright MRI shines light on chronic back pain and spine conditions
A one of a kind health care centre in Kamloops, BC is making significant progress in the diagnosis and treatment of chronic pain conditions, including back pain. The Welcome Back Centre is a multi-disciplinary health clinic that offers patients a team care approach. One secret to their success with patients is a piece of technology that is rarely found elsewhere in the country: Upright MRI. Many hospitals use ordinary or recumbent MRI, where the patient lays flat inside the machine. An upright MRI is different in that it can keep the patient standing or sitting, often in the position where the problem can be imaged and the pain is present.
When it comes to diagnosing spine conditions and detecting instability in the joints, upright MRI holds the advantage over traditional MRI. There are a couple of reasons for this distinction. Dr. Paul Ouimet, Chiropractor at the Welcome Back Centre states that gravity plays a major role in the way our spine functions. The space between our spinal discs is usually greater when we are laying down rather than sitting or standing. This could effect the image and mean the difference between a normal looking spine and a major problem on the MRI. Secondly, our bodies function upright which is often when we actually experience pain. It is important for doctors to have the ability to see what the anatomy looks like during the pain episode as the problem may otherwise be hidden. This was also previously demonstrated with common x-ray in recumbent versus standing or sitting imaging postures.
Dr. Richard Brownlee, Neurosurgeon and Director at the Welcome Back Centre says that detecting instability is the key difference between an upright MRI and an ordinary recumbent MRI. Instability is abnormal movement within a joint, whether it is your wrist or the relationship between two spinal vertebrae. Dr. Brownlee also stresses that demonstrating to a patient that there is nothing structurally wrong with their back is just as important as finding a major problem. If a patient can be reassured about the integrity of their spine, they are more likely to take up exercise and other wellness suggestions without fear of hurting themselves.
Research also demonstrates the profound difference between upright and ordinary recumbent MRI, especially when it relates to spinal conditions. A 2010 study of whiplash patients found that upright MRI detected trauma in 23.3% of cases versus 9.8% of cases imaged on the recumbent MRI. Other research papers also demonstrate situations where imaging was dramatically improved when an upright posture was possible.
This technology is helping to provide answers to patients who have gone years with inconclusive results. It can also assist in better identifying qualified spine surgery candidates, saving health care dollars and preventing painful failed surgery outcomes in the future.