Methods: Lumbosacral MRI films of patients who visited the outpatient department between January 2023 and March 31, 2024, were evaluated to check for technical inadequacies. Results: A total of 1,150 lumbar MRI sets from 100 MRI centers were examined. Thirty-five percent did not include T1 axial images, and 8% did not include T1 sagittal images. Thirty-eight percent did not specify the sagittal image sequencing (right-to-left or left-to-right). Eighty-five percent of the sagittal images were profiled from right to left, and 15% were profiled from left to right. Macnab’s recommendation was not followed in 970 sets. The axial sectioning of the scout films was nonparallel to the examined segment in 350 sets. The sacroiliac joint was not screened in 40% of the sets. The number of plates provided ranged from two to six films. Conclusions Based on the results obtained, we strongly recommend that radiologists form structured guidelines to be followed by MRI centers to ensure uniformity, address inadequacies, and minimize the chance of errors in diagnosis and subsequent treatment.

Methods: Lumbosacral MRI films of patients who visited the outpatient department between January 2023 and March 31, 2024, were evaluated to check for technical inadequacies. Results: A total of 1,150 lumbar MRI sets from 100 MRI centers were examined. Thirty-five percent did not include T1 axial images, and 8% did not include T1 sagittal images. Thirty-eight percent did not specify the sagittal image sequencing (right-to-left or left-to-right). Eighty-five percent of the sagittal images were profiled from right to left, and 15% were profiled from left to right. Macnab’s recommendation was not followed in 970 sets. The axial sectioning of the scout films was nonparallel to the examined segment in 350 sets. The sacroiliac joint was not screened in 40% of the sets. The number of plates provided ranged from two to six films. Conclusions Based on the results obtained, we strongly recommend that radiologists form structured guidelines to be followed by MRI centers to ensure uniformity, address inadequacies, and minimize the chance of errors in diagnosis and subsequent treatment.

Methods: Lumbosacral MRI films of patients who visited the outpatient department between January 2023 and March 31, 2024, were evaluated to check for technical inadequacies. Results: A total of 1,150 lumbar MRI sets from 100 MRI centers were examined. Thirty-five percent did not include T1 axial images, and 8% did not include T1 sagittal images. Thirty-eight percent did not specify the sagittal image sequencing (right-to-left or left-to-right). Eighty-five percent of the sagittal images were profiled from right to left, and 15% were profiled from left to right. Macnab’s recommendation was not followed in 970 sets. The axial sectioning of the scout films was nonparallel to the examined segment in 350 sets. The sacroiliac joint was not screened in 40% of the sets. The number of plates provided ranged from two to six films. Conclusions Based on the results obtained, we strongly recommend that radiologists form structured guidelines to be followed by MRI centers to ensure uniformity, address inadequacies, and minimize the chance of errors in diagnosis and subsequent treatment.

In general, the scientific literature recommends extended fusion of the lumbar decompressed level adjacent to a fused level. Tubular decompression of lumbar canal stenosis defies this concept as it minimizes collateral damage. This study explores the concept of tubular hybrid surgery, where tubular decompression is performed adjacent to a fused level. A descriptive study of the technique is presented with a few case examples. The concept of tubular hybrid surgery wherein tubular minimally invasive spinal fusion is performed at one level and microscopic tubular decompression is executed at the adjacent levels is discussed, along with clinical and biomechanical evidence and case examples. The tubular hybrid method represents a significant advancement in minimally invasive spine surgery. Larger long-term, multicentric, prospective studies are necessary to establish the benefits of the procedure.