POSTOPERATIVE MAGNETIC-RESONANCE-IMAGING WITH TITANIUM IMPLANTS OF THE THORACIC AND LUMBAR SPINE

WITHIN RECENT YEARS, the technologies of radiological imaging and spin al instrumentation have exponentially increased. New methods of preope rative imaging, that is, magnetic resonance imaging (MRI) and computed tomography, have allowed for a better understanding of surgical patho logy. Such an understanding is likely to lead to a more successful sur gical experience, which certainly is the case with spine surgery with instrumentation. However, after implantation of most instrumentation, imaging is greatly impaired. Metallurgic advancements in titanium were sought to reduce postoperative imaging problems. The purpose of this study is to assess the presence and extent of artifacts seen on postop erative MRI scans in patients with titanium spinal implants. Six patie nts, four with degenerative spine disease and two with neoplasms, had thoracic and/or lumbar spinal fixation performed with titanium instrum entation. All patients underwent postoperative conventional MRI with t he use of T1-weighted, T2-weighted, and gradient-echo sequences. The s cans and individual sequences were then analyzed for image quality. A progressive and significant increase in imaging artifact related to th e titanium spinal instrumentation was observed on the T1-weighted, T2- weighted, and gradient-echo sequences. Titanium spinal instruments do not allow optimal postoperative imaging on conventional MRI scanners.