MRI after Cervical Spine Decompression and Fusion Surgery: Technical Considerations, Expected Findings, and Complications

Cervical spine MRI is essential for evaluating potential complications and symptomatic degenerative changes following cervical decompression and fusion surgery. High-yield diagnostic interpretation considers the underlying surgical approach (anterior vs posterior), the time elapsed since surgery, and the clinical status of the patient to reliably differentiate expected postoperative changes from surgical complications. As cervical anatomy, such as the foramina and nerve roots, is smaller than that of the lumbar spine, MRI acquisition challenges include the demand for higher spatial resolution. Another unique challenge for cervical spine MRI is susceptibility to motion artifacts from swallowing, breathing, and cerebrospinal fluid pulsation. Modified MRI protocols, including the use of metal artifact suppression techniques, can help mitigate susceptibility artifacts from metallic implants. This focused review of postoperative cervical spine MRI discusses common cervical surgery decompression and fusion approaches and recommended MRI acquisition and interpretation algorithms, briefly considers radiofrequency coil selection, and illustrates complications in both early and delayed phases.