What does an MRI of the Spine Tell (2022)

An MRI spine is a unique test that tells us about your spinal cord, discs, and bones. We get a good view of the spinal canal, bony vertebrae, and disc spaces between vertebrae (spaces contain fluid & nerve roots) from the top down. We can assess any signs of fracture, spondylolisthesis. Where one bone displaces over another, often the result of wear and tear on hips) and narrowing of the canal. The MR spine also tells us a great deal about nerve roots. Nerve roots are the structures that carry our nerve signals to other parts of the body from your spinal cord. They are all important in terms of assessing your symptoms. But they can individually assess too using specific tests. Here we will discuss the different types of images. The requirement of an MRI, and also- why should you get the MRI for your spinal problem.

What does an MRI of the Spine Tell (1)

What are different images in an MRI Scan?

Everything is not visible from one direction. The images of the spine are taken in different planes for a comprehensive view of the spine. This helps in a better understanding of the condition and stage of the disease.

Usually, I will take 3 different views: Sagittal, Coronal & Axial (or transverse).

The Sagittal View

A sagittal view is looking at you standing up straight with a single shot image. This gives information about your bones and joints and discs space between vertebrae. If you have disc problems or osteoarthritis (arthritis is inflammation of joints) this view will show it the best.

It is also useful for looking at the alignment of your neck and spine as well as. Any change in size or position of nerve roots, changes in discs.

The Coronal View

The Coronal view is taken when you are lying flat/sitting up. It looks at your spine from the side. And helps in giving a very clear picture of the space between each vertebra-disc space. This gives information about disc problems that involve that disc/level of my spine and how much narrowing there may be. With this view, we can look at nerves coming off your spinal cord to the lower part. This is called cauda equina. Cauda equina control all function below L4 -L5 (the bottom of your spine) and assess for any problems there.

(Video) How to Read a Spine MRI

Axial View

In addition to the above views, radiologists can take an Axial View or T2 weighted view. This is looking at you lying flat on your back with a single shot image which gives me information about your bones and the space between vertebrae, discs spaces as well as pelvic structures (sacrum & coccyx).

It can be done when you are pregnant if we are assessing for pregnancy-related MSK issues. This view highlights anything that has changed since we took last year’s images i.e inflammation from an infection in the disc or changes due to osteoarthritis. It also looks at nerve roots individually: L4, L5, S1, S2, cauda equina.

This is a very useful sequence as it tells me about your discs and nerve roots from top to bottom and front to back of my spine.

When you need MR Spine is a non-invasive painless test this can repeat every 1-2 years if necessary looking for changes in the spinal cord, discs, or bones. It should not hurt! Repeat scans are helpful for determining whether there has been an improvement or deterioration in your condition.

They also enable accurate diagnosis when you have multiple symptoms. Symptoms like nerve root compression causing radiating pain down legs/to back of thigh & calf plus severe backache/stabbing type pains. These all can may need lots of different treatment options such as steroids, anti-inflammatories, physiotherapy, and possible surgery.

What is MRI-Spine used for?

MR spine helps in the following ways, to know better your spine.

(Video) How to Read a MRI of the Normal Lumbar Spine | Lower-Back | Vail Spine Specialist

  1. To give a baseline scan of your spinal cord, discs & bones.
  2. To assess for nerve root damage (radiating pain down legs etc).
  3. For post-operative assessment of your treatment/s.
  4. As part of my clinical assessment when you have multiple symptoms or new-onset symptoms plus other examinations to help with diagnosis.

Not all scans are the same! The better the picture quality/resolution the easier it is for me to diagnose correctly what is causing your symptoms.

A dye that enhances picture quality. This is a contrast MRI. It helps for clearer demarcation. It is your choice whether to have this. But it may be useful for differentiating between inflammation or scar tissue and injected material from working muscles when there is weakness in one part of the body vs. another part.

Contrast can sometimes cause some discomfort lasting 1-2 hours after the procedure. These are usually mild abdominal pains & nausea as well as urinary side effects. There will be a slight burning sensation with passing urine due to dye and possibly urinating more than usual).

There are certain contraindications against MR scanning if you are pregnant. The safety of MR scanning for pregnant patients has been well established.

What are the conditions mentioned in the MRI of spine scan report?

Disc space narrowing –

The disc spaces are the “gaps” between your vertebrae which are held together by disc. As we age disc spaces become less spacey and may collapse with or without symptoms. If they have collapsed we call this a Disc Bulge / Herniation. Narrowing refers to how far these discs have narrowed. Sometimes it’s a small amount and sometimes significant causing nerve compression.

Persistent/ongoing inflammation in discs- as opposed to some acute inflammation evident from recent injury or infection e.g viruses, bacterial infections, etc.

(Video) Your Radiologist Explains: Spine MRI

Osteoarthritis of the spine –

wear and tear arthritis of spine which can also cause pain but not always. Often conditions like osteoporosis or ankylosing spondylitis present with bone formation (bone spurs) around joints, tendons, and ligaments causing inflammation.

Know More- Spondylitis

Bone spurs – bony growths on the vertebrae often secondary to wear & tear arthritis of spine/osteoarthritis.

Facet joint osteoarthritis –

This is something that my patients may have had for a long time i.e months/years. These are only visible on MRI scan as it is not visible on X-rays (plain films). It causes severe pain and inflammation in the back which radiates into the legs, worsening with exercise due to increased movement at these joints. Patients often say they feel burning pains in the spine or hips when pushing down the pedal or turning quickly in the car etc.

Know more about – Facetal Arthropathy

Many patients keep on taking treatment unsuccessfully with painkiller medication and physiotherapy for months/years. Before MRI scan to show the underlying problem. Osteoarthritis of the spine can also cause pain but not always.

(Video) Lumbar Spine MRI by Eric Tranvinh, MD, Stanford Radiology

Disc herniation –

These can- “slipped” discs, bulging discs or even “ping-ponging” discs. The disc moves around causes compression on the nerve roots coming off our spinal cord at different levels. For example – cervical nerve root 1 compress by C5 disc when upper cervical damages. As well as inflammation in surrounding soft tissues such as muscles, ligaments, and tendons. It can lead to weakness or complete loss of function in arms and hands as well as severe pain, tingling/numbness radiating into arms & legs.

Spondylolisthesis –

This is a slippage of one vertebra over the other causing instability and pain at that level due to stress on ligaments attached to the bone. It can cause leg pains and sciatica-type pain going down the backside of your legs. Often associated with degenerate disc disease at adjacent levels or stenosis (spinal canal narrowing) which may have caused further damage to nerves exiting the spinal cord at different spinal levels resulting in radiculopathy (segmental nerve roots compression causing symptoms).

Know More- Spondylolisthesis

Spinal stenosis –

Narrowing of the spinal cord canal may have been caused by a previous injury or disease. Or by a degenerating disc in your spine. It causes severe pain and inflammation which radiates down into your legs worsening with exercise.

When you don’t have a proper diagnosis. You keep on taking medicines for years with no results. This is the reason, I am a bit adamant, at certain times, about the MRI test. Before starting the treatment.

Sacroiliac joint disease –

this is where there is some degeneration between the sacrum (part of pelvis i.e bottom) and ilium bone on the left-hand side: Pain comes from sacroiliac joints causing symptoms in the left buttock, down the back of the left thigh. Often associated with injury, degenerative arthritis in the lumbar spine.

(Video) Lumbar spine MRI scan, protocols, positioning and planning

Ligament laxity –

which means that your ligaments are more stretchy than normal usually caused by the repetitive stresses and strains (sometimes from sports activities or work-related) causing a lot of wear & tear on them over years/decades. It also causes weakness in your joints so you may not have much strength when trying to move these affected joints.

Instability at a joint –

instabilities around a joint can cause stiffness and immobility which may feel painful especially when moving as well as weakness if there has been past injury here too but it is very difficult to treat this without any investigations like MRI scans.

Why should you get an MRI of Spine when you have back pain?

Well, if you are suffering from back pain then the first thing to do is visit your doctor and get it checked out properly as there may be other underlying problems. MRI scan of the spine can provide much useful information about what is going on in our body like whether there has been any damage/instability at one level of our spine or not (which could be a risk factor for future injuries). This will help your doctor to assess if you have had an injury and guide the treatment plan accordingly.

FAQs

What does an MRI of the Spine Tell? ›

It can assess the disks to see if they're bulging, ruptured, or pressing on the spinal cord or nerves. The MRI also can help doctors: Evaluate symptoms such as lower back pain, leg pain, numbness, tingling or weakness.

What is the purpose of an MRI of the spine? ›

MRI uses a magnetic field, radio waves and a computer to create images soft tissues, bones and internal body structures. MRI of the spine allows physicians to examine the spine anatomy to rule out any structural abnormalities.

What will an MRI tell me about my back? ›

An MRI scan creates detailed pictures of your spine. It can pick up most injuries that you have had in your spine or changes that happen with aging. Even small problems or changes that are not the cause of your current back pain are picked up. These findings rarely change how your provider first treats you.

What does an abnormal MRI of spine mean? ›

What Abnormal Results Mean. Most of the time, abnormal results are due to: Herniated or "slipped" disk (lumbar radiculopathy) Narrowing of the spinal column (spinal stenosis) Abnormal wearing on the bones and cartilage in the spine (spondylitis)

Can you see nerve damage on an MRI? ›

Nerve damage can usually be diagnosed based on a neurological examination and can be correlated by MRI scan findings. The MRI scan images are obtained with a magnetic field and radio waves. No harmful ionizing radiation is used.

Can a pinched nerve be detected with an MRI? ›

MRI scans which show soft tissues, such as nerves and discs, are generally preferred over CT scans which show bony elements. Advanced imaging can show exactly which nerve or nerves are being pinched and what is causing the nerve to be pinched.

What happens if an MRI shows nothing? ›

The bottom line is that not all pain is able to be detected on an x-ray or MRI. That does not mean that there is nothing there that needs to be treated or diagnosed. In fact, it means that it is possibly a precursor to something going really wrong and then eventually needing surgery because it eventually winds up torn.

Does MRI show inflammation in back? ›

In comparison, MRI-proven spinal inflammation was found in 70–100% [5, 7, 12, 13, 16] of patients in other studies with patients who had a longer disease duration. Inflammatory oedematous spinal lesions were found in different anatomical structures in this study.

Does the sciatic nerve show up on an MRI? ›

The cause of sciatic nerve pain is usually diagnosed using an MRI. Patients are not exposed to radiation. In addition, this procedure causes no pain and requires no recovery time.

Which is better MRI or CT scan for spine? ›

Magnetic resonance imaging produces clearer images compared to a CT scan. In instances when doctors need a view of soft tissues, an MRI is a better option than x-rays or CTs. MRIs can create better pictures of organs and soft tissues, such as torn ligaments and herniated discs, compared to CT images.

What does an MRI show for lower back pain? ›

A lumbar spine MRI can detect a variety of conditions in the lower back, including problems with the bones (vertebrae), soft tissues (such as the spinal cord), nerves, and disks.

How long does an MRI of the spine take? ›

The test usually takes 30 to 60 minutes but can take as long as 2 hours.

Can you see spinal stenosis on MRI? ›

Since spinal stenosis is a gradual onset condition, the symptoms tend to start slowly and worsen over time. In fact, spinal stenosis may appear on an MRI or a CT scan without the patient having any symptoms at all.

Can MRI of spine show other organs? ›

Lumbar MRI obtained for low back pain may reveal findings within any of the organ systems included in the field of view.

What does a black disc on MRI mean? ›

Black disc is used to describe a dehydrated and totally degenerated spinal disc . It derives its name from the way it is seen on an MRI scan as a completely black disc. A normal healthy disc has a white center (nucleus) but as the disc degenerates its turns a darker color on the MRI scan.

What happens if an MRI shows nothing? ›

The bottom line is that not all pain is able to be detected on an x-ray or MRI. That does not mean that there is nothing there that needs to be treated or diagnosed. In fact, it means that it is possibly a precursor to something going really wrong and then eventually needing surgery because it eventually winds up torn.

Can MRI of spine show other organs? ›

Lumbar MRI obtained for low back pain may reveal findings within any of the organ systems included in the field of view.

Does the sciatic nerve show up on an MRI? ›

The cause of sciatic nerve pain is usually diagnosed using an MRI. Patients are not exposed to radiation. In addition, this procedure causes no pain and requires no recovery time.

Videos

1. MRI Lumbar Spine
(Madison Memorial)
2. Understanding Basic MRI of the Spine
(Leo Valentin MD)
3. What to Expect from an MRI
(RAYUS Radiology™)
4. X Ray versus MRI of the Spine
(ShimSpine)
5. How to Read a MRI of the Normal Thoracic Spine (Mid Back) | Vail Spine Specialist
(Donald Corenman, MD, DC)
6. Incidental findings and tumors / cancers on MRI
(Dr Christoph Agten)

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