MRI is vital resource in treatment of back pain
13 January 2009
Magnetic resonance imaging (MRI) is a growing technology providing an
increasing number of clinical benefits when used in the evaluation of
back pain according to an article in the January 2009 issue of the
Journal of the American Academy of Orthopaedic Surgeons. It is predicted
that over the next several years, additional technical developments will
allow MRI to provide even more useful orthopaedic benefits.
Co-author Victor M. Haughton, MD, department of radiology, University
of Wisconsin Hospitals and Clinics, says, "Because of the many different
ways to gather this important information, MRI can be used to identify
or display almost every type of spinal tissue or pathology. The imaging
sequence can be modified to meet many different clinical needs." Those
include: back pain, infection, tumour, trauma and vascular disease.
Researchers continue to find new ways to apply technologies that were
previously used exclusively on other areas of the body. MRI which is
considered safe, fast and versatile is now being used in several spinal
applications such as:
- intervertebral disk and facet joint degeneration;
- spinal canal stenosis;
- vascular disorders; and
MRI scans are produced by stimulating the protons in tissues and
liquids (such as fat, muscle, spinal cord, and fluid in the spine) using
radiofrequency waves in the presence of a magnetic field. MRI detects
the amount of energy emitted from these protons. This technology makes
MRI well suited to evaluate spaces between spinal vertebrae, bone
marrow, the spinal canal, and in soft tissues. Therefore MRI has been
shown to be useful for almost every spinal pathology including; diseases
of the spinal cord, nerve roots, vertebrae, disks and blood vessels.
With MRI there is no radiation risk to the patient.
Computed tomography (CT) has also improved in resolution and scanning
speed and is often the only imaging method available for patients with
pacemakers, nerve stimulators, or those who suffer from claustrophobia.
For these individuals, CT can provide structural information needed for
diagnosis in many back pain cases. However, CT does include some
exposure to radiation.
MRI, although a very important technology, should never take the
place of a thorough medical history and physical examination. Also,
there are often structural findings or "abnormalities" on MRI that are
not clinically relevant and not necessarily related to a patient's
symptoms. MRI findings must always correlate with the patient's clinical
"The possibilities of magnetic resonance have not yet been realized.
It is a rapidly evolving field. When we need tools to identify a
possible herniated disk, the simplest type of MR imaging or CT imaging
can be used successfully. However, if you want to find out which disk is
causing pain, which nerve is firing, which metabolites are present in
abnormal amounts, or how well the spinal elements are functioning, MR
will provide the answers," adds Dr Haughton.
Joseph P. Cousins, PhD, MD and Victor M. Haughton, MD. Magnetic
Resonance Imaging of the Spine. J Am Acad Orthop
Surg, Vol 17, No 1, January 2009, 22-30. The abstract is available
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