Related Experiment Video
Updated: May 9, 2026
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
Magnetic Resonance Imaging Before Spine Consultation Expedites Time To Surgical Intervention in Higher Acuity Spinal
Nicholas B Pohl1, Jonathan Dalton1, Rachel Huang1
1Departments of Orthopedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA.
Objective:
To evaluate the association between MRI timing relative to spine surgery consultation and in-hospital surgical workflow timelines.
Background Data:
Acute spinal conditions can have lasting effects on patients' and their families' quality of life. Few studies have evaluated barriers to early intervention.
Methods:
Patients who received an inpatient spine surgery consultation and underwent nonelective surgery during the same hospitalization were identified (2017-2022). Hospital admission timelines were evaluated, including the time from MRI completion to hospital admission, medical clearance, spine consultation, and procedure start, as well as length of stay (LOS). Patients were grouped by operative booking designation into high-acuity (levels 1-3; OR requested within 12 h) and low-acuity (level ≥4; OR requested within 24 h).
Results:
A total of 221 cases were included, including 82 high-acuity cases: 20 (24.4%) underwent MRI before consultation, and 62 (75.6%) did not. The most common primary diagnosis was cervical trauma (17.9%), followed by spinal epidural abscess (17.3%). High-acuity cases had shorter times from MRI to procedure (28.5 vs. 71.5 h; P<0.001) and from consult to procedure (33.2 vs. 70.9 h; P<0.001) than low-acuity cases. When high-acuity patients were stratified by MRI status before consultation, consult-to-procedure time was longer in the group without an MRI (38.4 vs. 17.2 h; P=0.002). The time from medical clearance to procedure and from admission to procedure did not differ significantly between the MRI consult timing groups. Timing variables did not differ based on weekday/weekend consult placements.
Conclusion:
High acuity spine cases in which MRI was obtained before consultation were associated with substantially shorter time to operative intervention compared with cases in which consultation preceded imaging. Further work to identify variables associated with high-acuity spine cases and to evaluate standardized MRI acquisition pathways may help reduce delays in operative care.
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