MRI Is Not a Fortune Teller

Magnetic resonance imaging–more commonly known as MRI–provides doctors with computerized pictures of tissues inside the body. This machine creates images that look like slices of the area your doctor is interested in. If a person has neck pain, for example, doctors can use MRI to determine exactly where the problem is and where to operate. But can the MRI give an accurate picture of whether the surgery will be a success?

Seventy-three patients requiring surgery for spinal stenosis were studied. Spinal stenosis develops when the tube surrounding the spinal cord narrows. The resulting pressure on the spinal cord causes “myelopathy,” a condition that can cause problems with the bowels and bladder, change the way a person walks, and affect a person’s ability to use his or her fingers and hands.

Fifty of the patients were men; 23 were women. Their ages ranged from 43 to 81 years old. The average age was 64.

The authors studied MRI scans taken of each patient before surgery. The authors wanted to compare whether certain qualities of the MRI were common in patients who didn’t do well after surgery. If patients with a particular finding on the MRI didn’t get good results from surgery, doctors might know not to suggest surgery for these kinds of patients.

The results showed that, for the most part, MRIs don’t predict how well a patient will do after surgery. The findings of one type of MRI pattern suggested there was greater damage to the spinal cord tissues. Patients with this MRI pattern tended to do poorly after surgery. But since only four of these patients were in the study, the results weren’t conclusive.

A combination of the patients’ ages, certain MRI patterns, and duration of symptoms seemed to be good predictors of how well the participants would do after surgery. Younger patients whose MRI scans didn’t suggest a lot of damage and whose symptoms hadn’t lasted as long were more likely to get good results from surgery.

MRIs can give lots of information about the spine. However, doctors don’t yet know how to use this information to predict how well people will do after surgery. The authors hope future research will expand doctors’ knowledge in this area.