Feature article

MRI assists in the identification of Spinal Stenosis

In today’s society, experiencing back pain or discomfort on a daily basis is extremely common. Whether it occurs because of an accident, strain, injury or just daily wear and tear, low back pain is the single leading cause of disability worldwide. In fact, experts estimate that 80% of the population will experience a back problem at some time in their lives.1 Spinal stenosis is one of the most common back conditions, effecting about 33% of the US population, specifically anyone 50 years or older.2  While these statistics make seem discouraging, today’s advanced imaging techniques and technology are making it possible to properly detect and treat many back conditions.

What is Spinal Stenosis?

Spinal stenosis is a degenerative spine condition that refers to the narrowing of the spinal canal or other nerve pathways in the spinal column.3 This narrowing can put pressure on the nerves travelling through the spine, causing negative side effects.

 In most cases, spinal stenosis occurs in the neck and the lower back. The location of the spinal stenosis determines how the condition is classified. Cervical stenosis indicates that the narrowing occurs in the part of the spine in the neck. Lumbar stenosis indicates that the narrowing occurs in the spine at the lower back. It is possible for someone to have more than one type of stenosis.

In a healthy spine, the spinal cord travels from the brain through the spinal canal, with individual nerves branching off the cord and extending throughout the body through openings in the vertebrae.3 However, over time and due to the natural aging process, gradual damage occurs to the spine, causing it to constrict. Degradation of the spinal cord can occur in many ways:  

  • The discs between vertebrae can herniate and bulge into the spinal canal
  • Bone spurs can form
  • Inflamed soft tissue
  • Ligaments of the spine can calcify
  • Vertebrae can slip and become misaligned

Depending on the severity of the narrowing, if nerves of the spinal cord become irritated, then chronic pain and other symptoms can develop.

Symptoms of spinal stenosis vary among individuals depending on the location of the stenosis, which nerves are affected, and the severity of the narrowing of the spinal cord. Common symptoms include numbness, tingling, or weakness in the extremities, problems walking, and pain in the neck and back.

However, these symptoms are common in many other back conditions, making it challenging for a physician to establish a diagnosis of spinal stenosis. Therefore, a physician requires an in depth anatomical view of a patient’s spine to properly diagnose spinal stenosis and determine the cause of the symptoms.

MRI Exam for Spinal Stenosis

Undergoing a magnetic resonance imaging (MRI) exam is an essential step in diagnosing spinal stenosis. An MRI scanner is a non-invasive, painless imaging technique that allows physicians to see the anatomical structure of the spine. Using a strong magnet to create a magnetic field around the patient and radio frequency pulses, an MRI machine can receive energy signals from the hydrogen atoms in a patient’s body. A computer then interprets the emitted energy signals and translates that information into a highly detailed image. A spinal MRI provides physicians with the most accurate visual data, increasing their confidence in their ability to establish a diagnosis.

When ordering an MRI to diagnose spinal stenosis, physicians are looking for specific information in the results, such as:

  • spinal alignment
  • disc height and hydration
  • vertebral body configuration
  • spinal canal size
  • pinched or inflamed nerves 4

If the MRI detects any variables that indicate spinal stenosis, the physician will use this information in conjunction with additional tests to fully establish the diagnosis. The MRI alone is not enough to establish a diagnosis, because artifacts in the scan can be misleading or could indicate a copycat condition. In addition, a physician cannot distinguish between painful and non-painful structures in the spine simply by reviewing an MRI.The MRI findings must be correlated with the patient’s physical exam, mobility tests, and possibly an X-ray or CT scan to determine the next course of action.

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Treating Spinal Stenosis

Studies show that nearly everyone aged 50 and older will develop some signs of spinal stenosis. Therefore, proper treatment and preventative measures are critical to ensuring the health of your spine. As back pain begins to develop, it is important to see a doctor. Often, non-surgical treatment, such as physical therapy, can resolve the back pain in a matter of weeks.

Typically, physicians will recommend this course of action before recommending an MRI spine scan. An MRI scan is usually required when conservative treatment such as physical therapy is not working, and more aggressive back pain treatments are needed in order to relieve symptoms.4

As advanced MRI technology continues to be more accessible to patients around the globe, more patients are receiving prompt and accurate diagnoses. Fortunately, spinal stenosis can be treated and recovered from, therefore an accurate spinal MRI is key when developing a course of action.

 

References

  1. "Back Pain Facts and Statistics". American Chiropractic Association. Web. July 23 2018. <https://www.acatoday.org/Patients/Health-Wellness-Information/Back-Pain-Facts-and-Statistics>
  2. U.S. Census Bureau (2016). American Community Survey 1-year estimates. Retrieved from Census Reporter Profile page for United States<https://censusreporter.org/profiles/01000US-united-states/>
  3. "What Causes Spinal Stenosis". Laser Spine Institute. Web. July 23 2018.<https://www.laserspineinstitute.com/back_problems/spinal_stenosis/what_causes/>.
  4. Shalen, Phillip R. "MRI Scan of the Spine". Spine-Health. December 20, 2002. Web. July 23 2018. <https://www.spine-health.com/treatment/diagnostic-tests/mri-scan-spine>.