Magnetic resonance imaging of the lower back. It is the preferred method for diagnosing disc herniation, nerve compression, and structural spinal problems.
Indication
- Persistent low back pain and pain radiating into the leg (sciatica)
- Diagnosis of lumbar disc herniation and assessment of nerve compression
- Suspected lumbar spinal stenosis (narrowing of the spinal canal)
- Numbness, weakness, or reflex changes in the legs
- Changes in urinary or bowel control (urgent evaluation for cauda equina syndrome)
- Follow-up of spondylolisthesis (vertebral slippage) and degenerative disc disease
- Differentiation of recurrent disease from scar tissue after lumbar surgery (with contrast)
Preparation
- Fasting is usually not required
- All metal items are removed (belts, removable piercings, watches)
- If lumbar surgery has been performed previously, the type of implant (screw, plate) should be reported
- Any pacemaker or neurostimulator (spinal cord stimulator) must be disclosed
- If you have claustrophobia, please inform your physician in advance
How it's performed
- The patient lies supine; a surface coil is placed at the lumbar level
- The examination takes approximately 15-25 minutes; remaining still is important
- T2-weighted sequences best show disc structure and the spinal cord
- T1 and STIR sequences reveal bone marrow changes and edema areas
- Disc herniation, nerve root compression, and the dural sac are evaluated in axial and sagittal sections
- Intravenous contrast may be administered for differentiation following previous surgery
Post-procedure
- There are no specific restrictions after the scan
- Results are reported by a radiologist; interpretation is provided by an orthopedist, neurosurgeon, or pain specialist
- A surgical decision is made based not on MRI alone, but on clinical findings and neurological examination together
- If sedation was used, driving on the same day is not recommended
Risks
- Rare allergic reaction to gadolinium contrast (if contrast was administered)
- Risk of nephrogenic systemic fibrosis in advanced kidney failure (very rare)
- Inability to complete the scan due to claustrophobia
- Heating risk with MRI-incompatible metallic implants
FAQ
I have back pain — is an MRI necessary?
No. Most back pain resolves spontaneously within 4-6 weeks. MRI is requested when pain is prolonged or when 'red flag' findings such as radiation to the leg, weakness, or changes in bladder/bowel control are present.
A herniated disc was seen on my MRI — do I need surgery?
No. The appearance of a herniated disc on MRI alone does not determine the need for surgery. Clinical findings, physical examination, and response to conservative treatment are evaluated together; most patients recover without surgery.
I had spinal surgery — can I have an MRI?
Most modern spinal screws are MRI-compatible and pose no problem. However, the type of implant must be known; please bring your surgical report with you.
Is the scan painful?
No. There is no pain during MRI; you only need to lie still in a narrow tube and tolerate the noise of the machine.
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