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 MRI tell

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.

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.    

  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.

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. 

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.

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.

Vaidya Pradeep Sharma (MD)

Sukhayu Ayurveda for most trusted Ayurvedic hospital for spinal problems

Sukhay Ayurveda is one of the prime institution of Ayurveda. National Accreditation Board for Hospitals and Healthcare Providers- famously known as NABH under quality council of India- awarded Sukahyu NABH accreditation in year 2017.

Vaidya Dr. Pardeep Sharma is "Chief Ayurvedic Physician" at Sukhayu Ayurved Jaipur. He is an M.D. (Ayurveda) doctor. He is the founder of the "Sukhayu Ayurved" and working with patients clinically since last 15 years. Vaidya Ji is well known for his specialisation in Ayurvedic treatment of different ailments. Among these diseases "To set the slipped disc to normal" is one. Vaidya Dr. Pardeep does it according to the scientific principles of Ayurveda. Under his