A thoracic spine MRI is an extremely valuable tool for evaluating pain, numbness, and other types of discomfort in the mid-back.
Starting from the base of the cervical spine, the thoracic spine consists of 12 vertebrae stacked on top of each other, numbered T1 – T12. While the cervical and lumbar sections of the spine provide mobility, this mid-portion of the spine is responsible for creating stability and support. A thoracic spine MRI provides detailed images of the vertebrae, soft tissues, and surrounding organs to help detect a variety of conditions including fractures, improper spine curvature, inflammation, infection, herniated discs, tumors, and spinal cord damage.
Whether you’ve already had a thoracic spine MRI or are planning to get one, understanding your report can be a little tricky. We spoke with three subspecialty radiologists who are experts in interpreting scans of the spine to find out what advice they have for patients. Here, they share their answers to commonly asked questions patients have about their thoracic spine MRI.
Tips for Understanding Your Thoracic Spine MRI Report
1. “My thoracic MRI report says I have degenerative changes; what does that mean?”
By, Dr. Max Wintermark Neuroradiologist
The phrase "degenerative changes" in a spinal MRI report refers to osteoarthritis of the spine. A certain degree of degenerative changes are normal with age and are not a cause of concern. However in some cases, for example when bone spurs develop and begin pinching a nerve, your doctor may develop a treatment or pain management plan.
One thing patients should keep in mind when reading their thoracic spine MRI report is that both the cervical and lumbar spine are more prone to degenerative changes. This is because most movement occurs in the upper and lower back – the cervical spine is responsible for all our neck movements, and the lumbar spine is responsible for the movements of the lower back. The thoracic spine, on the other hand, is tied to the ribs and the rib cage. It is a lot less mobile, providing support to the rest of the spine.
Another tip for the patients is to know that the thoracic spine along with the cervical spine contains and protects the spinal cords, whereas typically only nerve roots are present in the lumbar spinal canal. This has an impact on the type of conditions and the type of symptoms that can be observed in the thoracic spine. It’s important that your doctors understand the symptoms so that they can order the correct type of exam and examine the right portion of the spine.
2. “What does it mean if my thoracic spine MRI detects an exaggerated thoracic kyphosis?”
By, Dr. Andrew Kompel Musculoskeletal Radiologist
The thoracic (chest) portion of the spine has a normal anterior curvature. When this curvature becomes increased, the term is called kyphosis or exaggerated thoracic kyphosis. The most common cause is osteoporosis, usually occurring in older women, where the bones of the spine (vertebral body) become compressed, losing their normal shape. Other causes of kyphosis include loss of the function or strength of the muscles and ligaments supporting the spine and abnormal formation of the spine at birth. While mild kyphosis is usually associated with no symptoms, more severe curvature can be painful and disfiguring with physical therapy, and sometimes surgery, needed to correct the kyphosis.
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3. “What should my thoracic MRI report include? How can I know the report is thorough?”
By, Dr. Michelle Goñi Musculoskeletal Radiologist
One tip to understanding your thoracic spine MRI is knowing what the exam covers. A thoracic MRI report should discuss observations on soft tissues, such as the spinal cord, discs, muscles, and/or ligaments, as well as bone marrow. A thoracic spine MRI can diagnose disc herniation or nerve impingement, bone marrow diseases or edema secondary to recent fractures, and spinal cord lesions, among other conditions.
It is also imperative that a board-certified subspecialty trained Neuro or MSK (musculoskeletal) radiologist interprets the MRI. A neuroradiologist or MSK radiologist will be familiar with nuances of how different conditions present themselves on imaging. They will know exactly what to look for and can ensure nothing is missed. A detailed clinical history should be included for the radiologist so that they can address your clinical concerns.
About the Contributing Radiologists:
Max Wintermark M.D. is a Neuroradiologist and the current Chief of Neuroradiology at Stanford University. He is also a Professor of Radiology, President of the American Society of Functional Neuroradiology (ASFNR), and Chair of the Research Committee of the American Society of Neuroradiology (ASNR). Dr. Wintermark received training in Diagnostic Radiology at the University of Lausanne in Switzerland, followed by a fellowship in Neuroradiology at the University of California, San Francisco. He has extensive expertise in stroke, traumatic brain injury, epilepsy, movement disorders, and psychiatric disorders. He is also a renowned specialist in perfusion imaging.
Dr. Andrew Kompel M.D. is a Musculoskeletal Imaging Specialist and an Assistant Professor of Radiology at Boston University School of Medicine. Following a residency at Boston University Medical Center, Dr. Kompel completed a fellowship in Musculoskeletal Imaging and Intervention at Johns Hopkins Hospital. His areas of clinical and research interests include collaboration with orthopedists in quantitative cartilage analysis, sports-related injuries, and advanced MRI imaging. Has co-authored multiple peer-reviewed papers and has authored book chapters and review articles on various musculoskeletal topics.
Michelle Goñi M.D. is a Musculoskeletal Imaging Specialist. She completed her residency at the University of PR School of Medicine, followed by a Musculoskeletal Radiology fellowship at the University of Miami. Dr. Goñi is also currently a Diplomat of the ABR, a not-for-profit physician-led organization that oversees the certification and ongoing professional development of specialists in diagnostic radiology, interventional radiology, radiation oncology, and medical physics.
Interested in getting a second opinion from Dr. Wintermark, Dr. Kompel, Dr. Goñi, or one of our other subspecialists? Learn more here.