Use of titanium wire in cervical spine fixation as a means to reduce MR artifacts

MR imaging of the cervical spine is valuable for assessing traumatic injuries to the spinal cord and bony ligamentous structures. MR is also useful for detecting such long-term complications of spinal cord injury as syrinx, arachnoid cyst, cord adhesion, and persistent mechanical impingement on the spinal cord or spinal nerve roots. Treatment of cervical spine injuries that are mechanically unstable entails fixation and fusion. However, previous attempts at our institution to obtain clinically useful MR images of the cervical region after posterior wire fixation have failed because of image artifacts arising from ferromagnetic stainless steel wires. Use of biocompatible titanium wire for fixation allowed undistorted imaging of the spinal cord and spinal canal adjacent to the surgical fixation in a cadaver and in eight patients.