Lower back pain is one of the most common health concerns in the world and is often a concern of daily living or activity. While most resolve with time and conservative management, unresolved or severe symptoms could be indicative of underlying spinal problems that need help from advanced imaging modalities. The MRI LS (Lumbosacral) Spine Screening scan has become the gold standard for identifying lower back problems with the level of detail and accuracy only an MRI can provide. This informative guide will detail what an MRI LS Spine scan shows, when you should get it, and how it influences your care.
What is an MRI LS Spine Screening Scan?
An MRI LS Spine Screening Scan is an imaging technique that utilizes magnetic fields and radio waves to produce photographic images of the lower spine, also referred to as the lumbosacral spine. The lower spine consists of the lumbar vertebrae (L1-5), the sacrum (the five fused vertebrae of the lower spine), and the coccyx (the tailbone). However, these three collectively make up the lumbosacral spine. Speaking of the lumbosacral region is very responsibly done as it can represent as pain in the lower spine, nerve compression pain due to disc protrusion or stenosis, or some type of dysfunction associated with a spinal disorder. It is important to select MRI since it is the most effective means of developing imaging that will result in high-quality, resolution images of the bones, discs, nerves, and soft tissues in the lumbosacral region. The difference of MRI compared to other imaging estimates, such as X-rays or CT, is that MRI will not subject the appointment to ionizing radiation is fundamental to consider if there is any desire to repeat images of the same body region, since the adverse effects are less impactful than radiation. As a function, MRI imaging is incredibly safe and can be used essentially across all ages.
What does an MRI LS spine screening scan show?
An MRI Ls spine screening scan will identify a wide array of conditions within the lower back. Some of the most significant pathologies that can be detected include:
Disc Herniation (Slipped Disc): This is the most common finding on an MRI. Disc herniation occurs when the soft, gelatinous center of an intervertebral disc (nucleus pulposus) protrudes through a tear in the tougher outer layer (annulus fibrosus). This can compress nearby spinal nerves, and consequently, result in pain, numbness, tingling, or weakness of the legs, commonly referred to as sciatica. MRI serves as the reference standard for visualization of disc herniations and nerve root effects.
Spinal Stenosis: Narrowing of the spinal canal (the tube through which the spinal cord and nerves pass) or neural foramina (the locations through which nerve roots pass through the spine). Narrowing results in compression of the spinal cord or nerves, causing pain, numbness, weakness, and cramping of the legs when walking or standing. MRI produces detailed images of the narrowed spaces and the extent of nerve compression.
Spondylolisthesis: An abnormal forward or backward slippage of one vertebra over an adjacent vertebra. It can be caused by congenital, degenerative, traumatic, or stress fracture etiology. MRI definitively shows the vertebral slippage and any secondary nerve compression or bone marrow changes.
Degenerative Disc Disease (DDD) and Osteoarthritis: Over time, the intervertebral discs dehydrate and lose their flexibility, causing degeneration. This, along with facet joint alteration (small joints of vertebrae), may cause osteoarthritis of the spine. MRI may show signs of dehydration of discs, decreased disc height, bone spurs (osteophytes), and joint inflammation secondary to these changes. While these occur in asymptomatic individuals, in symptomatic patients, they are the cause of chronic back pain.
Spinal Infections: Although less common, infection of the vertebrae (osteomyelitis) or discs (discitis) can cause severe back pain and require prompt diagnosis and treatment. MRI is highly sensitive for detecting early inflammation, fluid collections (abscesses), and bone loss characteristic of spinal infections.
Spinal Tumors: Malignant and benign tumors may have an occurrence in the vertebrae, spinal cord, nerve roots, or surrounding soft tissues. MRI is crucial for identifying the lesions, their size, location, and relation to important neural structures. Contrast dye (gadolinium) is typically used to enhance the visibility of tumors.
Compression Fractures: These are fractures of the vertebral body, most commonly due to osteoporosis, trauma, or underlying conditions like cancer. MRI can directly diagnose acute fractures, differentiate them from more chronic healed fractures, and assess for associated bone marrow edema.
Inflammatory Conditions: Certain inflammatory conditions, such as ankylosing spondylitis, affect the spine. MRI can detect sacroiliac joint and spine inflammation, aiding in an early diagnosis and treatment plan.
Congenital Abnormalities: Occasionally, a person will have structural spinal abnormalities present at birth that can lead to back pain or other neurological problems. These congenital defects can be visualized with MRI.
When do you need an MRI LS spine screening scan?
While an MRI LS spine scan is a potent diagnostic tool, note that it’s not always the initial approach to treating back pain. Most cases of acute lower back pain resolve in a few weeks using conservative measures like rest, pain medication, and physical therapy. In such cases, routine imaging, including MRI, is frequently unnecessary and may even result in overtreatment and added anxiety.
Physician guidelines by groups such as the American College of Physicians highlight that MRI scans for lower back pain do not better patient outcomes in pain decrease, restoration of function, or quality of life for the majority of cases. Evidence shows that there is a high proportion of pain-free people who can have disc bulges or degenerative changes on an MRI scan, and it is difficult to identify the actual cause of pain based only on imaging.
Thus, when is an MRI Ls spine screening scan really necessary? The order for an MRI must be preceded by a careful clinical evaluation from a qualified healthcare practitioner based on the patient’s history, symptoms, and physical exam findings. An MRI is most commonly ordered in the following situations:
“Red Flag” Symptoms: These represent signals of serious underlying pathology that should be urgently investigated. Red flags include:
- Severe, sudden back pain that is accompanied by fever, chills, or unexpected weight loss. (Implies infection or tumor)
- New or increasing bowel or bladder incontinence. (May imply Cauda Equina Syndrome, which is a medical emergency)
- Gradual weakness, numbness, or tingling in both legs. (Implies serious nerve compression or involvement of the spinal cord)
- Back pain after an injury or trauma.
- Back pain in patients with a history of cancer, recent infection, or weakened immune systems.
- Severe, unrelenting pain at night that is not alleviated by rest.
- Persistent or Progressing Neurological Deficits: If the patient has severe and progressing neurological symptoms, including muscle weakness, foot drop, or severe sensory loss, an MRI is important to determine the cause of nerve compression and direct possible interventions.
Failure of Conservative Care: If severe or persistent lower back pain, particularly accompanied by radicular leg pain (sciatica), does not resolve after 4-6 weeks of adequate conservative treatment (e.g., physical therapy, medication, modification of activities), an MRI can be ordered to detect an anatomical cause.
Pre-surgical Planning: For patients contemplating spinal surgery (i.e., for serious disc herniation or spinal stenosis), an MRI is crucial to surgical planning. It gives precise anatomical data, allowing the surgeon to imagine the extent of the pathology and plan the procedure.
Follow-up of Known Conditions: In cases of known conditions in the spine such as multiple sclerosis, tumors, or inflammatory disease, MRI can be employed at regular intervals to track the disease process or the response to treatment.
What does the MRI LS Spine Exam entail?
The Technology
Magnetic resonance imaging (MRI) uses a large magnet, radiofrequency pulses, and a computer to create an image of your spine. You will lie on a table that slides into the tube-shaped MRI. The procedure is painless, and generally lasts about 30-60 minutes.
How do I prepare for the MRI?
You must remove all metal (jewelry, watch, keys, etc.) before the exam.
You should inform your doctor of any implants or pacemakers and if you are pregnant.
You should wear comfortable, loose clothing without metal fasteners.
If you are claustrophobic, you should discuss open MRI or sedation options with your doctor.
Conclusion
The MRI LS Spine Screening Scan is an excellent diagnostic tool to help identify the source and cause of lower back pain pathologies, neurological presentation, and/or other spinal pathologies. MRI provides a high level of visual detail for the bones, discs, nerves, and soft tissue of the lumbar spine, allowing for an early, relevant, and accurate diagnosis to ultimately enable targeted treatment to improve patient outcomes. If you have any questions regarding MRI LS Spine Screening Scans.
Frequently Asked Questions
Q: Is the MRI LS Spine scan safe?
Yes, it is a safe, noninvasive procedure without radiation exposure.
Q: How long does the scan take?
Typically 30 to 60 minutes, depending on the area being scanned.
Q: Will I feel any pain during the scan?
No, the MRI is painless, but some patients might be mildly uncomfortable from lying still and/or the noise of the machine.
Q: Can I have an MRI if I am pregnant?
MRI is usually safe in pregnancy, but you should always tell your doctor.
Q: What if I have metal implants or devices?
Always tell your doctor if you have implants; some devices may be safe in the MRI, while others may not.
Q: What conditions can be found by an MRI screening scan of the LS spine?
Several conditions can be detected using this scan, such as the following:
- Herniated or bulging discs
- Nerve compression or pinched nerves
- Spinal injury or trauma
- Tumors (benign or malignant)
- Infections or inflammation
- Spinal stenosis (narrowing of the spinal canal)
- Congenital (birth) abnormalities
- Degenerative changes like arthritis or spondylolisthesis.
Q: When should I get an MRI screening scan of the LS Spine?
- You may need this scan if you have:
- Persistent lower back pain for 4 – 6 weeks
- Sciatica (pain down the leg)
- Numbness, tingling, or weakness in the legs
- Loss of bladder or bowel control
- Back pain following a trauma or injury
- Possible spinal infection, tumor, or other serious underlying conditions
Q: What is different about the MRI LS Spine Screening Scan from other imaging studies?
MRI does not use radiation like X-rays or CT scans and provides superior images of soft tissue, nerve, and disc detail specific to diagnosing spinal issues that may not be captured by other imaging modalities.
Q: Is the MRI LS Spine Screening Scan safe?
MRI is safe for most people. However, certain contraindications exist for individuals with metal implants, pacemakers, or other implantable medical devices that require some caution. Notify your doctor of any medical devices or implants that could pose a problem before your MRI.
