1-Contrast administration:
-Given in the post operative lumbar spines either due to inflammatory or neoplastic lesions.
-Not given in other pathologies such as disc lesion, spinal trauma or congenital anomalies.
-It is given in case of lumbar disc lesion post operatively to differentiate between disc recurrence and granulation tissue resulting from operation.
-In case of post operative cervical spines, it is usually not given due to presence of the cord which prevents aggressive manipulation during operation by the surgeon, so it is not expected to find large amount of scaring in this type of operation.
-Failed back syndrome:
Occurs in a patient suffering from back pain, making operation for disc then followed by feeling the pain again.
The most common cause of this syndrome is spinal instability.
Laminectomy results in instability of the spine.
When MRI is done to this patient while lying down, instability of the spine is missed, while if he did dynamic MRI in the upright position, instability will be seen clearly.
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| In the image on the left, the patient is lying down with no evidence of instability, while in the image on the right, there is evidence of instability with pseudo disc bulge at the level L3-L4. |
-Dynamic MRI can also serve in presence of disc and ligamenta flava ligament hypertrophy as it make them clearly seen in the upright position than in the lying down position.
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| Flexion position of the cervical spines |
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| In neutral position |
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| In extension position |
-As it is a very expansive machine, many centers try to use myelography with contrast injection again to over come this financial problem.
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