[Emphasize functional magnetic resonance technology to enhance the clinical precise assessment of spinal diseases]

In the context of precision medicine, functional magnetic resonance imaging (fMRI) offers a key breakthrough in the diagnosis and treatment of spinal disorders, shifting the focus from morphological to functional assessment. Microstructural imaging techniques such as diffusion tensor imaging (DTI) of the spine enable early identification of pathological changes, such as demyelination and axonal degeneration, in the spinal cord and nerve roots, thereby facilitating ultra-early diagnosis and differential diagnosis. DTI can also assess the severity of neural injury, accurately localize the responsible spinal segments, and guide personalized and minimally invasive surgical planning. Preoperative DTI metrics have been shown to correlate significantly with postoperative functional recovery and have emerged as important imaging biomarkers for predicting outcomes. Furthermore, blood oxygen level-dependent fMRI studies in patients with spinal diseases have revealed functional reorganization and compensatory remodeling within sensorimotor networks in the brain, providing new insights into the central effects of spinal pathologies and underlying neural plasticity. By integrating functional and structural information, fMRI is currently propelling spine surgery toward a new era of earlier, more accurate, and more predictive precision-based care.