MRI After Spine Surgery: What Patients Should Know - Spinal DISC Center | Kris Radcliff, MD | New Jersey

wp-singular,page-template-default,page,page-id-17223,wp-theme-bridge,bridge-core-3.3.5,wp-schema-pro-2.12.4,qode-optimizer-1.2.3,qode-page-transition-enabled,ajax_fade,page_not_loaded,,no_animation_on_touch,qode-theme-ver-30.9.1,qode-theme-bridge,disabled_footer_bottom,qode_advanced_footer_responsive_1000,wpb-js-composer js-comp-ver-9.0.1,vc_responsive,elementor-default,elementor-kit-16783

MRI After Spine Surgery: What Patients Should Know

You had spine surgery. Later you get an MRI, and the report still says “severe stenosis” or “narrowing.” Before you panic, read this. A scary word on a report after surgery does not always mean the surgery did not work.

Don’t freak out about the report

It is very common for an MRI after surgery to describe narrowing, scar tissue or other changes, even when the surgery went well and the nerve has the room it needs. That is because the radiologist reading your MRI and the surgeon who did your operation are measuring two different things.

Radiologists and surgeons look at your spine differently

The radiologist is a doctor who specializes in reading images. Radiologists are not surgeons. They were not in the operating room. They usually do not know what the goals of your surgery were, what was found, or what was done. They describe the space around your nerves with geometry: how wide or narrow it looks on the picture compared to normal. Based on that, they may call it mild, moderate or severe.

The surgeon sees the nerve directly. During surgery, we measure the space for the nerve, and the size of a herniated disc, by looking at it and by checking it with delicate instruments. We ask a different question: does this nerve have enough room to live? We free the nerve until it does, or until we have removed as much as can be safely removed.

So the two can disagree. Your surgeon may have seen the nerve, checked it, and confirmed it has room. The MRI report may still say “severe narrowing,” because by the numbers on the picture, the space is smaller than a normal spine. That is a difference in approach, not necessarily a failed surgery. Many people with a report like that still do very well.

Why the picture can look worse than the result

Normal healing looks like “stuff” on MRI. Swelling, fluid and scar tissue after surgery can look like narrowing, especially in the first months.
Not everything should be removed. Some bone, joint and ligament has to stay to keep your spine stable. Surgeons remove what is needed to free the nerve, not everything that looks narrow.
Metal blurs the picture. Screws, rods and cages can cause dark spots or streaks (called artifact) right where we want to look. A report that says “limited by artifact” is not the same as “normal,” and it is not the same as “bad” either.
Words like mild, moderate and severe have no single agreed definition. Read why MRI reports differ.

Your surgeon should look at the images

This is the most important point. After spine surgery, the surgeon should review the actual MRI images directly, not just the report. Your surgeon knows what your spine looked like before, what was done, and what the goal was. They can tell whether what is on the picture is a real problem or just what a healed spine looks like.

A post-surgery MRI should always be judged together with how you feel and how you are doing on exam. Feeling better matters more than a word on a report.

Call your surgeon, don’t wait, if you have new or worsening weakness, numbness that is spreading, new trouble controlling your bladder or bowels, fever, or wound drainage. Go to the emergency room for loss of bladder or bowel control or numbness between the legs.

A few practical tips for MRI after surgery

Tell the MRI center about your implants. Most modern spine implants are safe for MRI. Bring your implant card if you have one.
Ask about a “metal artifact reduction” scan. Most newer scanners have special settings that make metal blur less. Your surgeon can request them on the order.
Sometimes a different test is better. MRI is best for nerves and discs. A CT scan is usually better to check whether a fusion has healed or a screw is loose. See which scan shows what.
Bring the actual images to your visit, not just the written report.

Had spine surgery and worried about a new MRI report? Send us your MRI images or call 609-800-3472.

This page is general information, not medical advice. Talk with your own doctor about your situation.