TYPE OF SCANS AND TESTS
SUPINE MRI
An MRI is a scan that uses strong magnets and radio waves to create detailed pictures of the inside of your body — especially soft tissues like the brain, spine, muscles, and organs. It does not use X-rays or radiation, unlike a CT scan. A supine MRI is the most common type, supine means laying down.
UPRIGHT MRI (uMRI)
An Upright MRI is a type of MRI scan where you are sitting or standing instead of lying down. It takes images of your body while it's under natural gravity and posture — which can reveal problems that don’t show up when lying flat. Often it's done as a dynamic scan with flexion-extension positioning. Upright MRI is the preferred imaging for diagnosing CCI. Unfortunately upright MRI machines are hard to come by, often requiring you to travel to find one. You can find the locatations of uMRIs in europe here.
CT SCAN
A CT scan(Computed Tomography) is a scan that uses X-rays and a computer to create detailed pictures of the inside of your body.
It’s like a more advanced X-ray that shows cross-section images (like slices of your body), allowing doctors to see bones, organs, blood vessels, and soft tissues more clearly.
ROTATIONAL CT SCAN
A Rotational CT scan is a special kind of CT scan (Computed Tomography) where imaging is done while the head or neck is rotated to the left and right, not just in a neutral (still) position.
Instead of just one static picture, it gives multiple 3D images of the bones at different head positions (usually at full left rotation, full right rotation, and neutral). This is the preferred way to diagnose AAI, also called rotational instability.
CONE BEAM CT (CBCT)
A CBCT scan is a special type of CT scan that uses a cone-shaped X-ray beam to create 3D images, mostly of the head, neck, teeth, jaw, and sinuses.
It gives high-detail images of bones and teeth with lower radiation than a regular CT. Recently this scan has been used to create dynamic (flexion/extension) imaging, as many don't have access to an upright MRI. This scan is useful in diagnosing both CCI and AAI.
MR/CT VENOGRAM
A venogram is a imaging test that shows how well your veins are working. It uses contrast dye to make the veins visible on scans, allowing doctors to see blockages, narrowing, or abnormal blood flow.
This test is especially useful for detecting problems in deep veins that can't be seen with ultrasound alone.It can be done both as an MRI and as a CT. It's one of the scans used to diagnose jugular stenosis and transverse sinus stenosis.
MR/CT ANGIOGRAM
An angiogram is a imaging test used to visualize blood vessels — especially arteries — to detect problems like narrowing, blockage, bulging (aneurysm), or abnormal connections.
The word "angio" means blood vessel, and "gram" means picture — so an angiogram is literally a picture of blood vessels. It can be done as either CT with contrast or MRI with or without contrast. It can be invasive, involving a catheter (thin tube) is inserted into an artery (usually in the groin, wrist, or neck) or non invasive. It's one of the scans used to diagnose jugular stenosis and transverse sinus stenosis.
FLEXION-EXTENSION X-RAY
A flexion-extension X-ray is a special type of X-ray imaging used to take pictures of your spine while it’s bent forward (flexion) and bent backward (extension). This is often the first scan a doctor orders when instability is suspected, however it is rarely enough to diagnose ligamentous laxity related instability such as CCI.
DIGITAL MOTION X-RAY (DMX)
A Digital Motion X-Ray (DMX) is a special type of real-time X-ray that shows how your bones and joints move while you're actually moving — like turning your head or bending your neck.
It’s like a video X-ray, allowing doctors to watch your joints in motion to detect problems that don’t show up when you're still. It's used by some practitioners to diagnose CCI, AAI and subaxial (below c2) instability.
LUMBAR PUNCTURE (LP)
A lumbar puncture (LP) is a procedure that measures cerebrospinal fluid (CSF) pressure in the lower back — which indirectly reflects the pressure inside the skull.After cleaning the skin and numbing the area, a thin, hollow needle is gently inserted between two vertebrae in the lower lumbar spine (usually between L3–L4 or L4–L5).
The needle passes into the subarachnoid space, where CSF flows around the spinal cord. Once the needle is in the correct space, it’s attached to a manometer — a small, clear, vertical tube that measures pressure.
ICP BOLT TEST
An ICP bolt (Intracranial Pressure bolt) is a small, screw-like device used to measure pressure inside the skull (intracranial pressure) directly and continuously. The ICP bolt is a type of invasive pressure monitor. It’s called a “bolt” because it’s a hollow screw that anchors a tiny pressure sensor into the skull.​​
INVASIVE CERVICAL TRACTION (ICT)
Invasive cervical traction is a medical procedure where a pulling force is applied to the cervical spine (neck) using surgically placed pins or screws in the skull or spine to help realign, decompress, or stabilize the neck bones.
Unlike regular traction (which uses external devices like a neck harness), invasive traction involves inserting hardware into bone to apply more precise or stronger traction. Some doctors use ICT to help determine if a fusion surgery would help alleviate symptoms
HALO VEST TRIAL
A Halo Vest Trial is a temporary, non-surgical test used to see whether stabilizing the head and neck with a rigid device (a halo vest) improves a patient’s symptoms — especially in cases of Craniocervical Instability (CCI) or Atlantoaxial Instability (AAI).