Featuring Dr. Audrey Spielmann, MD, FRCP(C)

Duration: 3 minutes, 3 seconds

The injuries that we see in the lumbar spine include ligamentous injuries, and most commonly herniations of the discs.

That can be seen in many different sports and just in everyday life as well. I would say that the most common sports that would be involved would include racquet sports, any sort of lifting sport and golfing with twisting and just carrying your sport equipment maybe would be a common way to get a lumbar spine herniation.

The MRI is the best way to look at disc herniations and to see the effect of the herniation on the nerve roots. We can see disc herniations with CT as well but we can't identify the exact relationship to the nerve roots, or to the spinal cord higher up in the spine.

So there is much greater detail with MRI. This is an example of a lumbar spine MRI on an ahtlete who plays hockey and there are the normal disc spaces within the spine.

At this level the disc space is lost and we can see disc material extending into the spinal canal. This is a very large disc herniation that is pressing on the nerve roots within the spinal canal. The CT scan demonstrates the bones nicely and is very helpful if we're concerned of a spine fracture.

What we don't see as well on CT are the soft tissues, particularly in the lower lumbar spine there can be quite a bit of artifact and the detail within the disc herniation is not as well seen.

In particular we don't see the impingement or compression of the nerve roots with CT, nor do we see the spinal cord with CT, so MRI gives us much better resolution.

The other benefit of MRI, we can view the anatomy in multiple planes. This is an axial image of the same area the disc herniation can be seen here. It's a very large disc herniation. What MRI can do for us is identify the nerve roots which are not seen specifically with CT. We can identify the degree of compression of the nerve roots.

The detail shown with MRI helps the surgeon decide whether surgery is needed for disc herniation or just if conservative management is sufficient. If you have any questions about lumbar spine MRI contact your family doctor or an imaging center.

Presenter: Dr. Audrey Spielmann, Radiologist, Vancouver, BC

Local Practitioners: Radiologist