Using the same MRI scan, let’s look at a dessicated disc. On the axial image, the neuroforamen are wide open and there is plenty of space available for the nerve roots. Inside the CSF is the spinal cord and the nerve root that go down to the legs. The spinal canal is filled with white fluid, called cerebrospinal fluid (CSF). The front and back of the disc, the annulus fibrosis is dark black, thick, and is not bulging into the spinal canal. The center of the disc, the annulus pulpous is relatively white. Above the disc is the 元 vertebral body and below the disc is the L4 vertebral body.
Each disc separates two bones called vertebrae in the spine. We are going to start with a normal level which has a normal intervertebral disc. There are 5 intervertebral discs in the lumbar spine. This is an MRI scan of a 40 year old male. Therefore, the critical task when it comes to interpreting MRI scan is CORRELATING the findings on the MRI scan with the patient’s complaints and with the physical exam. For example, in a paper published in the journal radiology, the researches found that approximately 90% of people WITHOUT any history of back pain in the last 6 months still have evidence of annular tears, disc degeneration, and disc bulging at one or multiple levels. Disc degeneration, bulging disks, and herniated discs occur very commonly and they may not be causing symptoms of pain. Most people, even if they don’t have any back pain, will still have evidence of abnormalities on MRI scans. We only describe it as abnormal when we compare it to the image of the baby on the left.
NORMAL SPINE XRAY SKIN
However, we could describe the skin on the right as “normal for age”. These findings would all be described as “abnormal”. If we were to look at the skin of the gentlemen on the right with a microscope, we would see evidence of degeneration, loss of elasticity (which is called elastosis), noncancerous skin growths (called keratoacanthomas), pigment changes such as liver spots, and thickening of the skin. The natural aging process causes changes to every structure of the human body. However, before we do, it is important that you understand that after the age of 30, essentially every MRI scan of the human body is abnormal.Įvery MRI scan after the age of 30 is “abnormal” We are going to look at examples of each of these conditions. The list of abnormal findings that we can see on an MRI scan include the following: disc desiccation disc degeneration disc bulging disc herniations annular tears spinal stenosis neuroforaminal narrowing
In addition to normal anatomy, we have also learned to identify a number of findings that may cause neck and arm pain or back and leg pain. We can clearly see the intervertebral discs, spinal cord and nerve roots. We can visualize the tiny details of normal and abnormal human anatomy. Magnetic Resonance Imaging is an amazing tool that allows us to see deep inside the human body with a degree of clarity that is absolutely amazing. The resolution and clarity of the images is better, we can see more fine detail, and this test uses harmless radio waves instead of ionizing radiation. These images are superior to CT scans and X-rays. The axial plane creates a cross section of the human body.Īn MRI image looks like a photograph, but it is actually a computerized image of the nuclear magnetic resonance of molecules inside the human body. The saggital plane sections the human body lengthwise. The two most common slices that we look at on MRI scans of the spine are the sagittal and coronal slices. This technique allows us to visualize anatomic structures from any angle and direction. Magnetic Resonance Imaging creates thin section images of the inside of the human body. MRI scans slice the human body into thin sections Today, the modern practice of spine surgery relies heavily on the interpretation of MRI scans. Prior to this, we were basically making educated guesses about what was wrong with the spine. The very first MRI scan of the human body was performed in 1977.
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