Spine MRI

Spine MRI: Information and Get a Scan

An MRI scan is a type of medical imaging scan that produces detailed images of the inside of the body, without the need for uncomfortable, invasive medical procedures or exploratory surgery. MRI stands for magnetic resonance imaging, and this type of scan uses radio waves and a strong magnetic field to create images of the bones, soft tissues, nerves and blood vessels.

Doctors use MRI scans to detect abnormalities and injuries and to diagnose different diseases and medical conditions, including those that affect the spine. 

What is a Spine MRI?

A spine MRI is a type of MRI scan that focuses on the back and spine. 

The spine is formed of five distinct parts:

• The upper spine and neck (the cervical spine)

• The middle back (the thoracic spine)

• The lower back (the lumbar spine)

• The sacrum, which connects the spine to the hips

• The coccyx, or tailbone 

Depending on your symptoms, you may have an MRI procedure on your entire back, or a certain part of it, such as a lumbar spine MRI, if you’re experiencing lower back pain. 

Reasons for a Spine MRI

You might be referred for a spine MRI when back or neck symptoms don’t settle on their own, when they point to a problem with a nerve or the spinal cord, or when another test has flagged something that needs a closer look. Because MRI shows soft tissue clearly, it is often the test used to find the cause of persistent pain.

The backbone, or spine, consists of 33 small bones called vertebrae stacked one on top of the next to provide support and stability. Each vertebra is connected to the next with a facet joint, a small piece of cartilage that allows flexibility and twisting movements of the spine. Between each vertebra is another piece of cartilage called an intervertebral disc, which cushions the vertebrae and acts as a shock absorber.

Together, the vertebrae form the spinal column. Running the length of the spinal column is a hollow space called the spinal canal. The spinal canal houses the spinal cord, a long collection of nerves that runs from the base of the brain down to the bottom of the lower back.

Due to the complex nature of the spine and all its bones, nerves and supporting soft tissue, some injuries and diseases can affect the spine and back.

Symptoms that suggest you need investigations, including a spine MRI scan to diagnose what’s happening in your spine, include:

• Back pain

• Back pain that radiates into the hips, buttocks and legs 

• Weakness

• Numbness

• Stiffness 

• Instability

• Swelling 

• Muscle spasms 

• Postural problems 

• Tingling that extends down an arm or leg into your hand or foot 

What a Spine MRI Can Diagnose

An MRI of the spine can diagnose many medical conditions, including the following: 

• Spinal Stenosis - Spinal stenosis causes the spinal canal to narrow, putting pressure on the nerves and spinal cord, causing pain, numbness and weakness in the back. 
• Degenerative Disc Disease - The soft, cushion-like intervertebral discs between each vertebra are under constant pressure and, as a result, can become prone to wear and tear or degeneration. Degenerative disc disease occurs when one or more discs have worn down so much that they’re causing pain, stiffness and immobility. 
• Herniated Discs - Intervertebral discs can also become damaged through injury or overuse, causing the soft jelly-like centre of the disc to bulge outwards, causing a herniated, or slipped disc. This results in pain, weakness and numbness as it pushes against the nerves of the spinal cord. 
• Nerve Compression - Also known as a pinched nerve, nerve compression in the spine occurs when a nerve is squashed or moved. This can be due to disc disease, a herniated disc, spinal stenosis or a tumour. A spinal MRI will diagnose nerve compression and discover the cause. 
• Spinal Tumours - Although rare, tumours can form in the spinal cord or the bones and soft tissues of the back and spine. They can be cancerous (malignant) or non-cancerous (benign), and an MRI procedure of the spine can help in the differentiation and subsequent diagnosis. 
• Spinal Infections - An infection in the bone or soft tissue of the spine causes pain, inflammation and swelling and can be detected on a spinal MRI scan.
• Multiple Sclerosis - Multiple sclerosis, or MS, is a neurological disease that causes nerve damage by attacking the protective, fatty layer of tissue called myelin that surrounds the nerve cells of the brain and spinal cord. Areas of this damage, called demyelination, can grow to become lesions that are visible on a spine MRI scan. 
• Fractures - Accidents, including falls and crush injuries, can cause fractures, or breaks, to the bones of the back. They can be minor and only picked up by a spine MRI after experiencing back pain for a while, or major and detected during emergency medical imaging following a serious accident.
• Scoliosis - an abnormal curvature of the spine, often detected in childhood, and may require surgery in later life to correct. 
• Inflammatory Conditions  - Inflammation can affect the bones and soft tissues of the spine, leading to pain, swelling, stiffness and immobility. Arthritis is a common cause of inflammation in the spine and can be detected during a spinal MRI. 

Types of Spinal MRI

There are different types of spine MRI scans, each focusing on a different part of the spine but working in the same way. Which one you have will depend on what part of the spine is affected by back pain and other symptoms. 

• Cervical Spine MRI - A cervical spine MRI creates detailed images of the bones and soft tissues of the neck and upper spine.
• Thoracic Spine MRI - A thoracic spine MRI scan concentrates on the bones and soft tissues of the middle back.
• Lumbar Spine MRI - A lumbar spine MRI focuses on the bones and soft tissues of the lower back. 
• Sacral Spine MRI - A sacral spine MRI scan produces detailed images of the bones and soft tissue of the area of the spine that connects to the hips. 
• Whole Spine MRI - If your back pain and other symptoms are affecting your entire back, you’ll be referred for a whole spine MRI scan that takes images of the complete spine. 

How a Spine MRI Works

An MRI scanner uses radio waves and a strong magnetic field to create detailed images. In the human body, each cell contains hydrogen atoms - when the radio waves and strong magnets are switched on, they temporarily disrupt the hydrogen atoms, which creates energy. 

Different structures, such as bone and cartilage, create different kinds of energy, and the MRI scanner picks up these differences and turns them into images. A radiologist can then interpret these images to diagnose abnormalities and disease. 

Some spinal MRI scans require a contrast dye, given orally as a drink or injected into a vein, to better highlight blood vessels and potential tumours. Your doctor will let you know if you need a contrast dye MRI. 

Benefits

Unlike X-rays and CT scans, MRI does not use ionising radiation, so there is no radiation exposure from a spine MRI. That makes it one of the safest imaging tests, and it can be repeated as needed to monitor a condition over time. The scan is painless and, for most people, straightforward.

Risks & Side Effects

The inside of an MRI scanner is a relatively small space, and the large magnets used cause a loud knocking noise when switched on and off. Therefore, it may be difficult for patients with claustrophobia to cope with having an MRI. An MRI scan also requires patients to remain still throughout, so it may also be a challenge for patients who feel pain or discomfort lying down flat or who find it difficult to remain still. 

Speak to your doctor before your scan if any of this concerns you. Your radiographer is there to make you feel as comfortable as possible. They’ll provide you with earplugs or headphones to help block out most of the noise, and you’ll be able to communicate with them through a microphone. They can also give you a mild sedative to help with feelings of panic and claustrophobia if necessary. 

Some people may experience an allergic reaction to the iodine and gadolinium used in the contrast dyes. If you have kidney disease or a known allergy to these chemicals, let your medical team know. 

How to Prepare for a Spine MRI

A spine MRI needs very little preparation. Ahead of the appointment you’ll be sent a safety questionnaire that asks about implants, devices and any metal in your body. Fill it in and bring it with you.
Wear comfortable clothing without metal zips, buttons, underwiring or fasteners. If there is no metal near the area being scanned you may be able to stay in your own clothes, otherwise you’ll change into a gown.

Unless you’re told otherwise, you can eat, drink and take your usual medications as normal. If your scan uses a contrast dye you may be given specific instructions. If you wear a continuous glucose monitor or insulin pump, check whether it needs to be removed, as the magnet can damage some devices. Anyone who needs sedation for claustrophobia should arrange this with their GP in advance, allow extra time, and bring someone who can take them home afterwards.

The Procedure Explained: What to Expect

A spinal MRI scan will take place in the following way:

1. Medical History Review - Your doctor will ask about your symptoms, how long you’ve had them and what, if anything, might make them feel worse or better. They’ll also ask about your medical history and previous scans or surgery. 
2. Change into a Gown - You’ll be asked to change into a hospital gown for your comfort and to ensure you’re not wearing any metal objects.
3. Removal of Metal Objects - Magnetic metal objects aren’t allowed inside an MRI scanner as they’ll be attracted to the magnets used, which can be very dangerous. Therefore, all clothing, jewellery, watches and hair clips must be removed. You’ll also be asked to leave mobile phones, keys, cash and bank cards in a safe place. Tell your radiographer if you have any internal metal devices, such as a pacemaker or cochlear implants that cannot be removed, along with any metallic tattoos, piercings or metallic shards or shrapnel that may be embedded inside your body. 
4. Screening for Implants or Devices - If you’re unsure if any metallic implants, devices, tattoos or embedded shrapnel you have are magnetic or your medical team is concerned they may be, they’ll screen you using a magnet device. If they find magnetic metals inside your body, they’ll decide if you’re suitable for a spine MRI. If you’re not, they may suggest a different scan, such as a CT scan or an x-ray. 
5. Positioning on the MRI Table - Your radiographer will be aware that you have back pain and will help you into position on the MRI table. You’ll be required to lie flat on your back and remain still while the table that slides in and out of the MRI scanner slowly moves and the images are taken. 
6. Ear Protection Provided - As the magnets switch on and off, they create a loud knocking noise. For this reason, you’ll be given earplugs or headphones to protect your ears. 
7. Scan Instructions Given - It’s important that you listen to the instructions given by your radiographer throughout so that the correct, high-quality images can be taken. They’ll ask you to remain still throughout, and there may be times when they’ll ask you to hold your breath for a few seconds to allow for more detailed images to be taken. 
8. MRI Scan Performed - Once you’re in position, your radiographer will turn on the MRI scanner and the scan will begin. A spine MRI usually takes 30 to 60 minutes, and it’ll take longer if you have a contrast dye MRI. If you have a contrast dye, you’ll be required to stay in the clinic for an extra 30 minutes to ensure you don’t react. Symptoms of an allergic reaction to a contrast dye include feeling breathless, weak, flushed or sweaty. If you begin to feel unwell at any point during the scan, let your radiographer know. 

Getting the Results

Your radiographer will send your MRI images to a radiologist for review, who will then discuss them with your consultant or referring doctor. They will then organise a consultation with you to discuss treatment options and your next steps. This may take a few days from the date of your spine MRI. 

What a Spine MRI Cannot Show

An MRI is very good at showing the structure of your spine, but structure and symptoms don’t always line up. The scan can show a bulging disc, a worn joint or a narrowed canal, yet it cannot always tell which of those findings, if any, is causing your pain.

This matters because age-related changes are common in people with no pain at all. A large systematic review found signs of disc degeneration in about 37% of pain-free 20-year-olds, rising to roughly 96% by age 80, with disc bulges following a similar pattern, from around 30% at 20 to 84% at 80. Many of these findings are a normal part of ageing rather than a diagnosis.

The practical takeaway is that a spine MRI is most useful when its images are read alongside your symptoms and a clinical examination, not on their own. A radiologist reports what the images show; your referring clinician decides what those findings mean for you. It is also why an incidental finding on a scan does not automatically call for treatment.

Costs

In the UK, a private MRI of the spine starts at around £250 and can go up to £1500, depending on the type of scan and if you have a contrast dye. Consultations and treatments will cost extra. 

Get a Spine MRI

Back pain can be debilitating, interfere with your work and your ability to relax and enjoy yourself and affect your day-to-day living. Waiting for an NHS appointment can take weeks or months. Booking a private spine MRI will help you find out what’s causing your pain and allow you to begin treatment sooner. 

Cervical Spine MRI

Our UK-wide teams of radiology specialists can help you get to the bottom of what’s causing your neck and upper back pain. Book a cervical spine MRI today. 

Thoracic Spine MRI

If middle back pain is getting in the way of your life, use our simple online booking system to book your thoracic spine MRI. 

Lumbar Spine MRI

Avoid lengthy waiting times and book a private lower back pain lumbar spine MRI with us today. 

FAQs

How Long Does a Spine MRI Take?

A spine MRI usually takes 30 to 60 minutes. You’ll be in the clinic for about an hour and a half if you have a contrast dye MRI.

What Does a Lumbar Spine MRI Show?

A lumbar spine MRI shows the bones, cartilage, muscles, nerves and blood vessels of the lower back.

What Does a Cervical Spine MRI Show?

A cervical spine MRI shows the bones, cartilage, muscles, nerves and blood vessels of the neck and upper back.

What Does a Thoracic Spine MRI Show?

A thoracic spine MRI shows the bones, cartilage, muscles, nerves and blood vessels of the middle back.

Can a Lumbar Spine MRI Show Cancer?

If a cancerous (or non-cancerous) tumour is present in the lower back, it will likely show on a lumbar spine MRI scan.

Does a Lumbar Spine MRI Show the Pelvis?

A lumbar spine MRI focuses on the bones and soft tissues of the lower part of the spine. The pelvis isn’t the primary focus, however this type of scan will show some of the pelvic region due to its proximity to the lower back. If you have pelvic pain, speak to your doctor about a pelvic MRI scan.

Does a Lumbar Spine MRI Show the Hips?

A lumbar spine MRI focuses on the bones and soft tissues of the lower part of the spine. The hips aren’t the primary focus, however this type of scan will show part of the hip anatomy due to its proximity to the lower back. A specific hip MRI is more beneficial if you have hip pain.

Does Your Whole Body Go In for a Cervical Spine MRI?

During a cervical spine MRI scan, the focus is on the neck and upper back. Your head, shoulders and upper back will enter the MRI scanner. Doctors and clinics vary, but in most cases the rest of your body will remain outside the machine.

Does Your Head Go In for a Lumbar Spine MRI?

During a lumbar spine MRI, the focus is on the lower back. Doctors and clinics vary, but in most cases you’ll enter the MRI scanner feet first while lying on your back, and you’ll only enter the machine up to your mid-back. The rest of your body, including your head, will remain outside the machine.

Do I Need a Referral for a Private Spine MRI?

You need a referral from a clinician before a scan, but you don’t have to arrange it yourself first. If you don’t already have one, our clinical team can provide a referral after a short consultation, with no obligation to book.

How Accurate Is a Spine MRI?

MRI is very sensitive at showing the structures of the spine. Its main limitation is specificity: it often picks up age-related changes that aren’t causing symptoms, so the images need to be read alongside your symptoms and an examination rather than on their own. Interpreted that way, it is a highly reliable tool for diagnosing spinal problems.

References 

Radiological Society of North America (RSNA) and American College of Radiology (ACR). Spine MRI. Radiologyinfo.org. https://www.radiologyinfo.org/en/info/spinemr

Johns Hopkins Medicine. Magnetic resonance imaging (MRI) of the spine and brain. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/magnetic-resonance-imaging-mri-of-the-spine-and-brain

Cleveland Clinic. Spine structure and function. https://my.clevelandclinic.org/health/body/10040-spine-structure-and-function

NHS. MRI scan. https://www.nhs.uk/tests-and-treatments/mri-scan/

NHS inform. Spinal stenosis. https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/neck-and-back-problems-and-conditions/spinal-stenosis/

Brinjikji W, et al. Systematic Literature Review of Imaging Features of Spinal Degeneration in Asymptomatic Populations. AJNR Am J Neuroradiol, 2015. https://pubmed.ncbi.nlm.nih.gov/25430861/