How to Read Your Spine MRI Report After a Car Accident

By Dr. Justin M. Dick, DC, CNMT, ARRT(N)(CT) | Clear Life Scoliosis and Chiropractic Center, Charlotte, NC | Published October 16, 2026

A spine MRI report has three parts: the technique, the findings, and the impression. The impression is the radiologist's summary and the part most people read first, but the findings section is where the detail lives. The words in it follow a published standard, and that standard says plainly what the words do not mean. Patients in Charlotte bring me reports after car accidents, and this is how I walk them through one.

The Technique Section

The technique section lists the sequences, meaning the different types of images taken. T1 and T2 images show anatomy. Fluid-sensitive sequences such as STIR make swelling and fluid bright. In 45 spinal trauma patients, readers agreed that sagittal STIR images were the most useful for seeing injury to the supraspinous ligament, interspinous ligament, ligamentum flavum, and cervical facet capsules, and that axial T2 images were best for the lumbar facet capsules (Crosby, Spine J 2011). If ligament injury is a concern and the study did not include a fluid-sensitive sequence, the report may not have been able to answer that question.

The Findings Section

Findings are usually listed level by level, such as C4-C5, C5-C6, L4-L5. At each level the radiologist describes the disc, the spinal canal, and the foramina, the openings where nerves exit.

The disc terms come from the 2014 consensus nomenclature of the North American Spine Society and two radiology societies (Fardon, Spine J 2014). A bulge involves more than 25% of the disc circumference and is not a herniation. A herniation is focal, under 25%, and is called a protrusion when its base is wider than the displaced material, or an extrusion when the displaced material is wider than its base or extends above or below the disc level. Sequestration means a fragment has separated from the disc.

What the Terms Do Not Mean

The radiology committee that endorsed the 2014 nomenclature wrote that its definitions are not intended to imply external causes such as trauma, do not imply a relationship to symptoms, and do not define a need for treatment (Williams, AJNR 2014). The update also emphasized the term "annular fissure" in place of "annular tear." A report that says annular fissure is describing a separation in the disc's outer fibers. It is not stating that the crash caused it, and the older word "tear" was never meant to say that either.

Many of these findings are common without pain. In pain-free adults, lumbar disc bulges ranged from 30% at age 20 to 84% at age 80 (Brinjikji, AJNR 2015), and 87.6% of healthy volunteers had cervical disc bulging (Nakashima, Spine 2015). Some findings are more common in people who hurt. In adults 50 or younger, disc extrusion, protrusion, and Modic type 1 endplate change were all significantly more common in people with low back pain (Brinjikji, AJNR 2015).

The Impression

The impression summarizes the findings the radiologist considers most relevant. It is written without the patient's exam in front of the radiologist, so it cannot say which finding explains the symptoms. That connection comes from the clinical exam.

Questions to Ask About Your Report

Which levels have findings, and do they match the side and location of my symptoms? Does any finding involve the spinal cord or a nerve root? Did the study include a fluid-sensitive sequence such as STIR? Was the study compared with any prior imaging of the same region? Is there anything the MRI was not designed to show, such as excessive motion between vertebrae? A clinician should be able to answer each of these from the report and the exam together.

For an example of how post-collision imaging findings and outcomes are documented in the peer-reviewed literature, read Dr. Justin Dick's published case report on refractory lumbar pain following a motor vehicle accident in a geriatric patient.

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Frequently Asked Questions

What are the main sections of a spine MRI report?

A spine MRI report has a technique section listing the image sequences, a findings section that usually goes level by level, and an impression that summarizes the findings the radiologist considers most relevant.

What is the difference between an annular fissure and an annular tear?

They describe the same finding, a separation in the outer fibers of the disc. The 2014 nomenclature emphasized annular fissure in place of annular tear, and its definitions are not intended to imply trauma as a cause (Williams, AJNR 2014).

Does my MRI report prove the car accident caused my disc problem?

No. The standard disc definitions do not imply trauma, symptoms, or need for treatment (Williams, AJNR 2014). Prior imaging, symptom timing, and the exam connect a finding to a collision.

What does STIR mean on an MRI report?

STIR is a fluid-sensitive MRI sequence that makes swelling bright. In spinal trauma, sagittal STIR images were rated most useful for seeing injury to several posterior ligaments (Crosby, Spine J 2011).

Are disc bulges on MRI normal?

They are common without pain. In 1,211 healthy volunteers, 87.6% had cervical disc bulging (Nakashima, Spine 2015). Some findings, such as disc extrusion, are more common in people with back pain.

Who can go over my spine MRI report with me in Charlotte, NC?

Dr. Justin Dick, DC, CNMT, ARRT(N)(CT), reviews spine MRI reports with car accident patients at Clear Life Scoliosis and Chiropractic Center, 8814 Rachel Freeman Way, Suite 103, Charlotte, NC 28278, phone 980-368-0766. Personal injury patients are treated on a lien basis, with no out-of-pocket payment at the time of care.

Sources and Evidence Tiers

1. Fardon DF, Williams AL, Dohring EJ, Murtagh FR, Gabriel Rothman SL, Sze GK. Lumbar disc nomenclature: version 2.0. Spine J. 2014;14(11):2525-2545. PMID 24768732. LinkEvidence tier: Expert consensus (NASS, ASSR, ASNR task forces)
2. Williams AL, Murtagh FR, Rothman SLG, Sze GK. Lumbar disc nomenclature: version 2.0. AJNR Am J Neuroradiol. 2014;35(11):2029. LinkEvidence tier: Editorial by the ASSR/ASNR nomenclature committee (expert consensus)
3. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. PMID 25430861. LinkEvidence tier: Systematic review
4. Brinjikji W, Diehn FE, Jarvik JG, et al. MRI findings of disc degeneration are more prevalent in adults with low back pain than in asymptomatic controls: a systematic review and meta-analysis. AJNR Am J Neuroradiol. 2015;36(12):2394-2399. PMID 26359154. LinkEvidence tier: Systematic review and meta-analysis
5. Crosby CG, Even JL, Song Y, Block JJ, Devin CJ. Diagnostic abilities of magnetic resonance imaging in traumatic injury to the posterior ligamentous complex. Spine J. 2011;11(8):747-753. PMID 21840264. LinkEvidence tier: Prospective diagnostic accuracy study (45 patients)
6. Nakashima H, Yukawa Y, Suda K, Yamagata M, Ueta T, Kato F. Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects. Spine. 2015;40(6):392-398. PMID 25584950. LinkEvidence tier: Cross-sectional study

Service Area

Clear Life Scoliosis and Chiropractic Center sees personal injury and spinal imaging patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, and Fort Mill SC.

Related Pages

• Personal injury and car accident spinal care in Charlotte
• Dr. Justin Dick's research
• Case report: refractory lumbar pain after a motor vehicle accident
• Research and evidence at Clear Life
• Questions and answers
• Our team
• Press
• Book your evaluation
• Contact Clear Life

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This article is educational and is not a diagnosis. Imaging decisions depend on an in-person examination.