This article provides a foundational understanding of cervical spine MRI reports, clarifying basic elements and common terms. This information is for educational purposes only and should not replace professional medical advice or a diagnosis from a qualified healthcare provider.
Decoding Cervical Spine MRI Basics
A cervical spine MRI uses strong magnets and radio waves to create detailed pictures of the neck region of your spine. Unlike X-rays, MRI does not use radiation and excels at visualizing soft tissues such as intervertebral discs, nerves, and the spinal cord. This non-invasive imaging technique allows medical professionals to assess conditions not visible on other types of scans.
The MRI machine generates a powerful magnetic field, which, combined with radiofrequency pulses, causes hydrogen atoms in your body to temporarily realign. As these atoms return to their normal positions, they release signals that a computer processes into two-dimensional images. These images, often called “slices,” can be viewed from different angles.
Common image “slices” include sagittal, which provides a side view of the spine, and axial, which offers a cross-sectional view. Different “sequences” are also used to highlight specific tissues or abnormalities. T1-weighted sequences typically show anatomical details well, with fat appearing bright and fluid appearing dark. T2-weighted sequences, conversely, make fluid and areas of pathology appear bright, useful for identifying inflammation or disc issues.
Identifying Key Spinal Structures
The cervical spine consists of seven stacked bones, labeled C1 through C7, which support your head and allow for a wide range of neck movements. C1, known as the atlas, is ring-shaped and supports the skull, while C2, the axis, has a unique bony projection called the dens that allows for head rotation.
Between each vertebra, from C2 down to C7-T1, are intervertebral discs. These discs act as cushions and shock absorbers, appearing as horizontal bands between the vertebral bodies on sagittal views. On T2-weighted images, healthy discs typically appear bright due to their water content, with a brighter central nucleus pulposus and a darker outer annulus fibrosus.
The spinal cord, a major part of the central nervous system, runs through a protective bony channel called the spinal canal, formed by the stacked vertebral bodies. On MRI, the spinal cord appears as a distinct structure surrounded by cerebrospinal fluid (CSF), which looks bright on T2-weighted images. Nerve roots branch off the spinal cord at each level, exiting through small openings called neural foramina, which can be seen on axial and oblique views.
Understanding Common MRI Findings
Various changes can be seen on a cervical spine MRI, some common and not always symptomatic. Disc herniations are a frequent finding, occurring when the disc material pushes outward beyond its normal boundaries. A “disc bulge” involves a broad, symmetrical extension of the disc where the outer layers remain intact but stretched.
“Disc protrusion” is a more localized herniation where the disc material pushes out, but its base is wider than the part that extends furthest. In contrast, “disc extrusion” occurs when the disc material breaks through a tear in the outer annulus, and the displaced material has a narrower neck than its dome, or it extends above or below the disc level. These herniations can potentially press on nerves or the spinal cord, depending on their size and location.
Spinal stenosis refers to a narrowing of the spinal canal or the neural foramina, the openings where nerve roots exit. This narrowing can be caused by disc issues, thickened ligaments, or bony overgrowths. On MRI, severe spinal stenosis might show the spinal cord appearing compressed, with a reduction or absence of surrounding cerebrospinal fluid at the point of narrowing.
Degenerative changes are also commonly observed and generally increase with age. “Disc desiccation” indicates a loss of water content in the intervertebral discs, causing them to appear darker on T2-weighted images and potentially leading to reduced disc height. “Osteophytes,” or bone spurs, are bony growths that can form along the edges of vertebrae as discs break down, and these can also contribute to narrowing and nerve compression.
Making Sense of Your MRI Report
Your MRI report is the radiologist’s professional interpretation of the images, providing a written description of the findings. This report uses specific medical terminology to describe structures and abnormalities in your cervical spine. Familiarizing yourself with these terms can help you better understand your results.
Common terms you might encounter include “desiccation,” “osteophyte,” “foraminal narrowing” or “foraminal stenosis,” “spinal canal stenosis,” “herniation” (including “bulging,” “protrusion,” or “extrusion”), and “effacement” or “compression.” While understanding these terms is helpful, your referring physician will correlate the MRI findings with your clinical symptoms and provide a comprehensive diagnosis and treatment plan.