Prone Position Magnetic Resonance Imaging

What is prone position Magnetic Resonance Imaging (MRI)?

Prone position MRI is a diagnostic imaging technique for the study of the position of the filum terminale with respect to nerve radicles inside the vertebral canal and more precisely within the meninges. This method was recently described in the 2013 publication by colleagues at the University of Hiroshima in the scientific journal J Neurosurg Spine entitled "Use of prone position magnetic resonance imaging for detecting the terminal filum in patients with occult tethered cord syndrome” Nakanishi K et al . J Neurosurg Spine. 2013 Jan; 18 (1): 76-84.

Prone position MRI is not widely known and routinely performed in hospitals for several reasons:
- is a new technique described only a few years ago;
- it is an examination that needs a learning curve for which an initial practice is necessary to obtain a good quality of the exam;
- it is used for the instrumental comfort to the clinical suspicion of the presence of a rare pathology, in reality it is more frequent than one might think, called occult tethered cord.

Prone position MRI allows to identify a position of the filum terminale compatible with the presence of the occult tethered cord, this pathology can also be associated with Chiari malformation or Low Lying Cerebellar Tonsils (LLCT) which can be diagnose with standard cervical MRI.

In Affidea Iniziativa Medica  in Monselice (Padua) since 2014, the year following the publication of the prone position MRI, thanks to the collaboration between Milena Calderone, neuro-radiologist and Neuroradiology Dipartment  director of  Affidea Veneto, and Vanni Veronesi, internationally renowned neurosurgeon who performs an innovative minimally invasive surgical technique in local anesthesia of extradural section of the filum terminale he published in the American scientific journal Operative Neurosurgery “Transhiatal Approach to Filum Terminale Externum Sectioning in Adult Patient With Tethered Cord Syndrome: Case Report” Operative Neurosurgery, Veronesi V. et al Volume 15, Issue 1, 1 July 2018, Pages E1-E4", was born a protocol, unique in the world, of instrumental investigation, with lumbar MRI in a prone position, and minimally invasive surgical treatment for the occult tethered cord.
For more information on the pathology of the occult tethered cord and on the possible associated clinical disorders click on the following link.

What are the risks and contraindications of prone position MRI?

Like any type of magnetic resonance imaging, this test does not pose any risk to the patient, because it is a harmless test for the human body as it does not use ionizing radiation.
The MRI can therefore be repeated even after a short time.
Prone position MRI can not be performed on patients with controindication to MR like pacemakers, neuro-stimulators, metallic valvular prostheses, or vascular, if not explicitly "MRI-safe or conditional".
Each foreign metal body must be removed, if present inside the body must be reported and verified by radiologists.
In patients with fixed metal prostheses (hip or knee) or synthetic means (nails or screws) for fractures or orthodontic devices, the possibility of performing the examination is related to the part of the body to be studied and the which the prosthesis is made of.
For pregnant patients, the examination, even if not contraindicated, is not recommended in the first three months and in any case must be performed only if absolutely not postponing.

AFFIDEA centers where you can book the prone position MRI exam:

In the Veneto region (Northern Italy)

Iniziativa Medica di Monselice (PD)

To book a Prone Position Magnetic Resonance Imaging at Affidea Iniziativa Medica please contact us at +39 0429 78 66 66 or write an email to info.iniziativamedica@affidea.it