Understanding Common Spine Terminology on MRI: A Patient’s Guide

Navigating the results of an MRI can be challenging, especially when confronted with complex medical terminology. However, it’s important to remember that many MRI findings are often asymptomatic, as imaging studies have shown. For patients visiting Desert Spine and Sports Physicians, understanding these terms is crucial for effective communication and treatment planning. Below is a comprehensive guide to some of the most common MRI spine terms patients might encounter.

Annular Fissure (Annular Tear)

An annular fissure is a tear in the outer ring (annulus fibrosus) of the intervertebral disc. This fissure can be asymptomatic or associated with back pain.

Disc Bulge

A disc bulge occurs when the disc pushes outward but remains intact. Most disc bulges do not actually cause pain unless they compress a spinal nerve root, which is not very common.

Disc Degeneration

Disc degeneration is a common part of aging and involves the gradual deterioration of the intervertebral disc. This may be associated with “disc desiccation” (loss of signal), which refers to decreased water within the disc; a desiccated disc appears as a “darker” disc on an MRI. Over time, there may also be “decreased disc height.” Again, disc degeneration is part of the aging process and does not cause spine pain in the majority of cases.

Disc Herniation

A disc herniation occurs when the nucleus pulposus, the soft, jelly-like center of a spinal disc, pushes through a crack in the tougher outer annulus fibrosus. If the herniation compresses or irritates the nerve, there can be associated pain, numbness/ tingling, and/or weakness in the arm or leg. Types of herniations include:

• Protrusion: The disc extends beyond its normal boundary; the base of the protruded disc material is wider than its ‘dome.’
• Extrusion: The base is narrower than the extent of the herniation and may extend above or below the disc level.
• Sequestration: The disc material migrates and becomes separated from the rest of the herniation.

Facet Arthropathy

Facet arthropathy involves the degeneration of the facet joints, which are the small, paired joints on each side of the spine that connect the vertebrae from the top of the neck to the lowest part of the back. Facet arthropathy can lead to spine pain and/or stiffness. Note that this term can be interchangeable with other commonly used terms, including “facet hypertrophy” and “spondylosis” (described below).

Foraminal Stenosis

Foraminal stenosis describes the narrowing of the foramina, the opening through which each nerve root exits the spinal canal. This can be associated with disc degeneration, facet arthropathy, osteophytes, and spondylolisthesis (all defined here). When this finding is associated with spinal nerve root compression, there can be pain, numbness/tingling, and/or weakness in the arm or leg.

Lateral Recess Stenosis

Lateral recess stenosis is a specific type of spinal stenosis (described below) where the narrowing occurs in the lateral recess, the outer part of the spinal canal through which the transiting or passing nerve root travels. This can also lead to pain, numbness/tingling, and/or weakness in the leg.

Modic Change (Endplate Edema)

Modic change refers to a change in the MRI signal seen in the vertebral endplate adjacent to or next to the disc. When this finding is associated with disc degeneration (described above), it may be described as Type 1, 2, or 3, which correlates with different stages of the degenerative cascade. Symptoms can present as axial back or neck pain that does not radiate into the limb.

Osteophytes (Bone Spurs)

Osteophytes, or bone spurs, are bony projections that form along the facet joint or another bone margin due to arthritis or degenerative changes. When these osteophytes compress nerves, they can cause pain, numbness/tingling, or weakness in the arm or leg.

Spinal Stenosis

Spinal stenosis is a narrowing of the spinal canal that can put pressure on the spinal cord or nerves traveling through the spine. It most commonly occurs in the lower back and neck and can cause pain, numbness/tingling, and/or weakness in the limb. In the lower back, it can also cause symptoms of heaviness or weakness in the legs with walking, also called neurogenic claudication.

Spondylolisthesis

Spondylolisthesis occurs when one vertebra slips forward or behind the adjacent vertebra. This is often associated with facet arthropathy (defined above) and some cases of bilateral spondylolysis (defined below). This slippage can sometimes cause nerve compression, leading to pain, numbness/tingling, and/or weakness in the arm or leg.

Spondylolysis

Spondylolysis is a defect or fracture of the pars interarticularis, a small bony structure connecting the facet joints of the spine, often referred to as a “pars defect” or “pars fracture.” This finding is often seen in adolescent athletes such as divers and gymnasts and can cause significant pain in the lower back. Spondylolysis can also be seen in the adult spine where it is a chronic finding and not a source of pain.

Spondylosis

Spondylosis is a general term for age-related wear and tear affecting the spinal discs and facet joints. This finding can be asymptomatic or associated with pain or stiffness in the neck or back that does not radiate into the limb. Note that this term often gets attributed to arthritic changes of the facet joints, but the term facet arthropathy (described above) is more specific.

Synovial Cyst

A synovial cyst is a small fluid-filled sac that arises from the facet joint and contains the same synovial or joint fluid found within this joint. These cysts can cause pain, numbness/tingling, and/or weakness in the leg or arm if they extend into the spinal canal and compress the nerve root.

Tarlov Cyst

A Tarlov cyst is a dilation of the nerve root sheath or outer covering of the nerve, which is filled with cerebrospinal fluid. This cyst is typically found in the sacral region at the base of the spine. Tarlov cysts are typically asymptomatic but, in some cases, cause pain, numbness/tingling, and/or weakness.

Understanding Your MRI Report

Understanding these terms can help you interpret your MRI report more effectively and have a better discussion about your physical medicine and rehabilitation treatments with your healthcare provider. At Desert Spine and Sports Physicians, our non-surgical specialists are dedicated to ensuring you have the information and support you need to make informed decisions about your healthcare.

Book a Consultation with Arizona’s Leading Spine Specialists

Navigating the medical terminology associated with MRI spine reports can be daunting, but understanding these terms can empower you to take an active role in your healthcare. It is important to note that many people with abnormal imaging findings do not experience symptoms. In fact, studies have shown that a large portion of asymptomatic patients have positive imaging findings.

If you have any questions or need further clarification, do not hesitate to reach out to our clinic. The Arizona-based physiatrists at Desert Spine and Sports Physicians are here to support you on your journey to better spinal health.