Spine MRI Scan - Risks, Benefits, and Contraindications

Introduction:

Magnetic resonance imaging is a procedure wherein a combination of large magnets and radio waves produce detailed images of the organs and structures of the body. It was developed in the 1980s and is a valuable tool in diagnosing various diseases and conditions. It can be performed on any body part and shows images of soft tissues, organs, and bones. It helps to differentiate between fat, water, and muscle tissues. More detailed and accurate diagnoses can be made with MRI scans; it is a safe diagnostic procedure because ionizing radiation is not used, as compared to computed tomography (CT) scans.

What Is a Spine MRI Scan?

The spinal cord (vertebral column), a major component of the central nervous system, extends from the base of the skull to the upper part of the lower back region. It controls various reflexes in the body by carrying sensory and motor signals to and from the brain. The vertebral consists of 33 vertebrae; cervical (seven), thoracic (twelve), lumbar (five), sacral (five), and coccygeal (four) vertebrae. Low back pain is one of the common conditions, and magnetic resonance imaging is an effective and painless procedure to diagnose the cause of the same. An MRI of the spine specifically helps in imaging the different areas of the spine (cervical, lumbar, and thoracic) along with intervertebral disks and spaces and helps diagnose the exact location and cause of the disease.

How Does Magnetic Resonance Imaging Procedure Function?

An MRI machine is a large cylindrical-shaped machine. It creates a strong magnetic field around the patient and, along with radio waves, alters the hydrogen atom alignment in the body. When the nuclei of the cells align back to their normal position, it sends radio signals that are analyzed by the computer and converted into a two-dimensional cross-sectional image. It can be performed with a contrast material to enhance the visibility and clarity of the image.

Why Is a Spine MRI Scan Done?

Indications of MRI scan include:

• Developmental disorders of the spine.

• Injuries or fractures of the spinal cord.

• Abscess or infections of the spinal cord.

• Herniation or bulging of intervertebral disks.

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• Persistent severe lower back pain.

• Back pain associated with fever.

• Signs of spinal cord tumors.

• The presence of fluid in the brain is called hydrocephalus.

• Degenerative changes in the spinal cord due to age.

• Treatment planning during spinal surgery.

What Are the Associated Risks With a Spine MRI Scan?

• MRI scan is risky for patients with metal implants such as pacemakers, metal screws, or pins placed during treatment procedures.

• Allergic reactions may occur due to the contrast dye material used during the MRI procedure.

• The presence of any tattoos or drug patches may lead to skin irritation or a burning sensation during the procedure.

• Changing magnetic fields with time can produce loud knocking noises and may harm the ears if adequate ear protection is not used.

• Patients must remain still during the procedure, which may be difficult for infants and children or old patients, during which sedation or anesthesia may be required, which may cause difficulty breathing and low blood pressure.

How to Get Prepared for a Spine MRI Scan?

• When the doctor has recommended an MRI scan of the spine, the patient is asked to fill out a form or a questionnaire which helps the medical team to know the patient.

• The patient is asked about the presence of any metal implants in the body, such as pacemakers, stents, cochlear implants, artificial joints, and limbs. In the case of patients with pacemakers, it may be deactivated with pre and post-monitoring (in cases of emergency), or if it is not possible, a CT scan is performed.

• Removal of all jewelry and metal piercings and wearing of the hospital gown.

What Happens During an MRI Scan?

• The patient is asked to lie on the bench or the scanning table of the MRI machine, which slides the patient into the scanning machine. Straps and pillows may be provided to prevent movement during the procedure, which may hamper the image quality.

• In some cases, a contrast dye material (gadolinium dye) is injected into the vein in the arm or the hand to obtain additional information. It might sometimes cause itching, headache, nausea, and a salty or metallic taste.

• If the patient is scared of closed spaces (claustrophobic) or experiences severe pain while lying down for more than ten minutes, the patient is referred to a physician for prescribing a relaxant or painkiller medication.

• During the scan, intermittent humming, clicking, and knocking sounds are heard, and patients are given earplugs or headphones to listen to music that masks the noise.

• The patient is asked to remain still during the scan to obtain a good-quality image. The MRI technician can see and hear the patient throughout the scan, and any assistance needed can be provided to the patient.

• The MRI scan procedure would take approximately 40 to 60 minutes, and once it is completed, the scanning table slides out, and the intravenous line, if inserted, is removed.

What Happens After an MRI Scan?

• The patient is asked to get up slowly and move to avoid any dizziness from lying flat during the procedure; if any sedatives are administered, the patient is asked to rest until the sedative effect fades off, and driving is not recommended.

• If a contrast material is injected, the patient is asked to drink lots of water (at least 50 to 60 ounces), to eliminate the dye within 24 hours from the body. In cases of allergic reactions, they should be reported to the doctor.

• After the MRI scan, a report is given, and a radiologist examines it to arrive at a diagnosis.

What Are the Contraindications of a Spine MRI Scan?

Some of the contraindications of a spine MRI scan include the following:

• Patients with cardiac pacemakers that are old models or that cannot be deactivated are contraindicated as the scanner magnets can move or heat the devices.

• Patients with spinal cord stimulators implanted under the skin may get damaged or dislodged.

• Cochlear implants (hearing aids) worn by deaf people may be damaged or dislodged, leading to pain, discomfort, and device malfunction.

• Orthodontic braces, retainers, fixed appliances, metallic fillings, or implants may get heated or damaged and interfere with the image quality.

Conclusion:

Magnetic resonance imaging (MRI) is a diagnostic procedure wherein a combination of large magnets and radio waves produce detailed images of the body tissues. It is a large cylindrical-shaped machine with a strong magnetic field and uses radio waves to produce detailed images of the desired body parts. It is a safe and accurate procedure that helps diagnose various diseases and conditions, especially degenerative disk diseases and spinal cord injuries, and aids in treatment planning.