From the Guidelines
Yes, a patient with vertebral rods from spinal surgery can generally undergo a Magnetic Resonance Imaging (MRI) scan, as several imaging modalities, including MRI, are useful and complementary in assessing patients with thoracic back pain and instrumented spinal fixation history. According to the most recent guidelines from the Journal of the American College of Radiology 1, an MRI of the thoracic spine, either with or without IV contrast, is usually appropriate as the next imaging study in this scenario.
When considering an MRI for a patient with vertebral rods, it's essential to note that most modern spinal hardware is made from titanium or titanium alloys, which are MRI-compatible and cause minimal interference with the imaging 1. However, older implants containing stainless steel or certain other metals may pose problems, as they can heat up during an MRI or distort the images.
Key considerations for undergoing an MRI with vertebral rods include:
- Informing your doctor about your spinal hardware to verify its compatibility
- The radiologist may need to use special MRI sequences to minimize any artifact caused by the metal
- Bringing surgical records or implant documentation to the appointment to determine the safest approach for the scan
- Potential image quality issues directly around the hardware, but the MRI can still provide valuable diagnostic information about surrounding tissues
The American College of Radiology guidelines 1 support the use of MRI in patients with instrumented spinal fixation history, emphasizing its importance in assessing hardware position and integrity, spinal alignment, fusion, and identifying findings suspicious for infection or postoperative complications.
From the Research
MRI Compatibility with Vertebral Rods
- A study published in 2021 2 found that MRI following scoliosis surgery with long implant constructs is safe with the patient in supine position, although susceptibility artifacts can severely limit the diagnostic value.
- The study examined the MRI compatibility of long pedicle-screw-rod constructs at 1.5 T and 3 T using standardized methods of the American Society for Testing and Materials (ASTM) and found that the maximum heating in the magnetic field was 1.3 K.
- The study also found that large spinal implants are not necessarily a contraindication for MRI, and MR conditional status can be examined according to the ASTM standards F2182, F2119, F2213, and F2052.
Safety of MRI with Vertebral Rods
- The same study 2 found that a metallic pedicle-screw-rod system could be reliably and safely examined in all combinations of length, configuration, and material in a B0 at 1.5 T and 3 T.
- According to ASTM F2503, the examined pedicle-screw-rod system is MR conditional, and especially young patients can benefit from a non-ionizing radiation MRI examination.