Related Experiment Video
Updated: Jun 8, 2026
Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Relationship between spinal magnetic resonance imaging findings and candidacy for spinal surgery
Frederick Cheng1, John You, Y Raja Rampersaud
1University of Toronto, Department of Surgery, Toronto Western Hospital East Wing 1-441, 399 Bathurst St, Toronto, ON M5T 2S8.
Objective:
To compare the prevalence of spinal abnormalities found on magnetic resonance imaging (MRI) in symptomatic surgical candidates and non-surgical patients.
Design:
Retrospective cohort study.
Setting:
A single academic spine surgery practice in Toronto, Ont.
Participants:
A total of 1586 symptomatic patients referred during a 32-month period; based on chart review, patients were classified as surgical candidates (n=722), non-surgical patients (n=690), or indeterminate regarding surgical candidacy (n=174).
Main Outcome Measures:
Prevalence rates of different spinal abnormalities between the 2 cohorts, including type, severity, and number of levels of abnormalities detected on lumbar MRI.
Results:
The total number of abnormalities did not differ between the 2 groups (P=.26). The non-surgical group exhibited more degenerative disk disease (P<.01), while surgical candidates had a higher prevalence of spinal stenosis and spondylolisthesis (P<.01). In multivariate analysis, age (adjusted odds ratio [AOR] per 10-year increase 3.33, 95% confidence interval [CI] 3.32 to 3.33), disk herniation (AOR 1.49, 95% CI 1.16 to 1.89), spinal stenosis (AOR 1.61, 95% CI 1.26 to 2.05), and spondylolisthesis (AOR 2.83, 95% CI 2.08 to 3.88) were independent predictors of surgical candidacy.
Conclusion:
These results might enable physicians without specialty training in spinal disorders to more effectively use MRI reports when deciding on referral to surgical or non-surgical specialists. In jurisdictions with long wait times for elective spinal surgery consultation, a more directed referral is one of many steps necessary to improve patient access and management.
