Spine Radiology
ARTICLE 09
Spine Radiology · Special Topics

Structured Reporting Spine MRI

Reproducible MRI report template

Section · Special Topics Updated · March 2026 Read · ~2 min

Structured Reporting — Spine MRI

Overview

Structured reporting ensures consistent, comprehensive evaluation of spine MRI and clear communication with referring clinicians. This article provides a template framework for spine MRI reports.

Cervical Spine MRI Template

Clinical Information: [Indication, symptoms, relevant history]

Technique: [Sequences, planes, contrast administration]

Alignment: Cervical lordosis (maintained/straightened/reversed). Listhesis (present/absent at each level).

Vertebral Bodies: Marrow signal (normal/abnormal). Compression fractures (present/absent). Hemangiomas. Endplate changes (Modic type).

Intervertebral Discs: At each level (C2-3 through C7-T1): disc height, signal, herniation (protrusion/extrusion, central/paracentral/foraminal, laterality), effacement of the cord or nerve roots.

Spinal Canal: Central canal diameter and any stenosis (mild/moderate/severe). Cord signal (normal/abnormal — T2 hyperintensity suggesting myelopathy).

Neural Foramina: Each level bilaterally — stenosis (none/mild/moderate/severe), nerve root compression.

Spinal Cord: Caliber (normal/atrophic/expanded). Signal (normal/abnormal). Syrinx.

Posterior Elements: Facet joints, ligamentum flavum, interspinous ligaments.

Paravertebral Soft Tissues: Normal or abnormal.

Lumbar Spine MRI Template

Similar structure but adapted for the lumbar spine:

Conus Medullaris: Position (normal at L1-L2 or below). Signal.

Cauda Equina: Normal or abnormal (clumping, enhancement, mass).

Intervertebral Discs: At each level (L1-2 through L5-S1): disc height, signal, annular fissure, herniation (protrusion/extrusion/sequestration, central/paracentral/foraminal/far lateral), nerve root compression.

Central Canal: Stenosis grading at each level.

Lateral Recesses: Stenosis bilaterally at each level.

Neural Foramina: Stenosis bilaterally at each level.

Clinical Pearl

A structured report should answer the referring clinician's specific question first, then provide the systematic evaluation. If the question is "L4-5 disc herniation?" — answer that directly in the impression before listing all other findings. Structured reporting improves completeness but should never come at the expense of clear, direct communication.

Key Points

References

  1. Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK. Lumbar disc nomenclature: version 2.0: Recommendations of the combined task forces of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology. Spine J. 2014;14(11):2525-45. doi:10.1016/j.spinee.2014.04.022. PMID: 24768732. Available from: https://pubmed.ncbi.nlm.nih.gov/24768732/

  2. Pfirrmann CW, Metzdorf A, Zanetti M, Hodler J, Boos N. Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine (Phila Pa 1976). 2001;26(17):1873-8. doi:10.1097/00007632-200109010-00011. PMID: 11568697. Available from: https://pubmed.ncbi.nlm.nih.gov/11568697/

  3. Nobel JM, van Geel K, Robben SGF. Structured reporting in radiology: a systematic review to explore its potential. Eur Radiol. 2022;32(4):2837-2854. doi:10.1007/s00330-021-08327-5. PMID: 34652520. Available from: https://pubmed.ncbi.nlm.nih.gov/34652520/

  4. Caglayan L, Ugurlu T, Bolog N, Yoon D, Nour Y, Péporté A, Andreisek G, Brendle C. Structured vs. unstructured MRI reporting for lumbar spine degenerative conditions: a comparative evaluation using a custom radiology template. Skeletal Radiol. 2026;55(1):81-95. doi:10.1007/s00256-025-04981-8. PMID: 40751740. Available from: https://pubmed.ncbi.nlm.nih.gov/40751740/

  5. European Society of Radiology (ESR). ESR paper on structured reporting in radiology. Insights Imaging. 2018;9(1):1-7. doi:10.1007/s13244-017-0588-8. PMID: 29460129. Available from: https://pubmed.ncbi.nlm.nih.gov/29460129/