Spine

The MMI Advantage

Experience and Expertise

MMI’s scientific experts have contributed hundreds of publications to the scientific literature on spine imaging and research. No other core lab offers our unique combination of experienced readers, scientific expertise, and specialized technology for spine clinical trials.

Modality Expertise

X-ray

MRI

CT

Ultrasound

MMI has extensive experience with motion preserving technology, including total disc replacement, facet replacement, disc repair and regeneration, and dynamic stabilization therapies. Our spine fusion experience includes assessments of allografts, autografts, and bone graft substitutes. We also have experience with deformity correction, interspinous distraction, and fracture stabilization and healing technologies. We are leaders in the evaluation of biologic products for bone and soft-tissue repair and have evaluated an array of novel treatments to slow or reverse disc degeneration and promote bone healing following spine fusion procedures.

We are experienced in virtually all major quantitative and semi-quantitative scoring systems to assess disease severity and response to therapy from medical imaging. We support image calibration strategies through the use of XCalibR™, MMI’s proprietary X-ray Calibration Ring marker. When appropriate, we apply validated, computer-assisted methods to objectively document the effect of new treatments. MMI’s proprietary and patented QMA^® technology produces accurate and reproducible measurements from spine radiographic images and has been published in over 200 peer-reviewed articles. Learn more about QMA^®.

WHAT WE OFFER

Analysis Capabilities

Quantitative spine measurements (e.g. rotation, translation, center of rotation, disc height, lordosis)

Spinal stability and alignment, including deformity correction (e.g. sagittal balance, Cobb angle)

Bony bridging and fusion, including extent of bony integration

Bone density and volume from QCT

Quantification of bone formation or removal

Structural bony anatomy (e.g. bone defects, osteophytes, Schmorl’s nodes, stenosis)

Vertebral augmentation and height restoration

Fracture and fracture healing

Disc composition and hydration, including qualitative, semi-quantitative, and relaxation mapping techniques (e.g. T2 mapping, T1ρ mapping)

Soft tissue structure and morphology (including annulus, nucleus, ligaments)

Position and volume changes of injectable materials

Implant stability and fixation

Implant interface remodeling

Custom implant analyses (e.g. preoperative planning, custom assessment development)

High-precision measurements of disc angle in flexion and extension using MMI’s proprietary QMA^® analysis technology

MR relaxation mapping to quantify disc quality during repair and regeneration

3D render of spine fusion to evaluate device and hardware positioning, bone-implant interface changes, implant integrity, and more

Measurement of vertebral body height restoration after vertebroplasty

Segmented disc volume overlaid on MR image slice

Quantity and quality of spine motion (e.g. angular motion, center of rotation) following total disc replacement, evaluated using MMI’s proprietary QMA^® analysis technology

PostOp (color) CT image overlaid on the PreOp (grayscale) image, showing regions of bone that were removed during decompression (white arrows).

3D CT visualization to assess form and function of the spine, including changes due to treatment

Some of Our Experts

John Hipp, PhD

Co-founder

Dr. Hipp is the Former Director of the Spine Research Lab at Baylor College of Medicine. He has over 30 years’ experience in quantitative imaging methods for spine research and is a recognized leader in spine related research. He has published over 100 imaging-related papers and book chapters, managed development of more than 75 spine-related imaging charters, and is a reviewer for eight leading journals including Spine and The Spine Journal. For his outstanding contributions, Dr. Hipp has received the prestigious AAOS Kappa Delta Orthopedic Research Award and NASS 2022 Henry Farfan Award.

Mark Schweitzer, MD

Vice President of Health Affairs,
Wayne State University

Dr. Schweitzer is fellowship-trained in osteoradiology, and has over 30 years’ experience in research, education, and clinical practice. Dr. Schweitzer is the former presiding officer of the Radiological Society of North America (RSNA) and International Skeletal Society (ISS), is the current Editor-in-Chief of JMRI, and serves on the Editorial Board of MRM. He has published over 400 peer-reviewed papers, 68 book chapters and 4 books, and delivered 800 lectures in 38 countries. Dr. Schweitzer is also an experienced scientific advisory panel member for FDA and NIH.

Relevant Scientific Resources

Guidance Spine

How MMI Navigates the Complexity and Variability of Radiographic Lumbar Fusion

Radiographic spine fusion assessment is complicated by a lack of standardized criteria, highlighting the need for imaging expertise during clinical trials.

Publication Spine

MMI Investigates Spinal Instability Using the Sagittal Plane Shear Index (SPSI)

In a research letter in Spine, MMI collaborated with researchers to investigate the SPSI as an objective measure of instability in lumbar stenosis patients with degenerative spondylolisthesis.

Guidance Spine

Why You Need an Imaging Core Lab: FDA's Guidance on Imaging in Spinal IDEs

Since 2000, the FDA has explicitly described the importance of radiographic evaluation in spinal studies in primary and secondary endpoints.

Key Publications Involving MMI

Auerbach JD, Namdari S, Milby AH, et al. The parallax effect in the evaluation of range of motion in lumbar total disc replacement. SAS J. 2008;2(4):184-188.

Hipp JA, Guyer RD, Zigler JE, Ohnmeiss DD, Wharton ND. Development of a novel radiographic measure of lumbar instability and validation using the facet fluid sign. Int J Spine Surg. 2015;9:37.

Pearson AM, Spratt KF, Genuario J, et al. Precision of lumbar intervertebral measurements: does a computer-assisted technique improve reliability? Spine (Phila Pa 1976). 2011;36(7):572-580.

Reitman CA, Hipp JA, Nguyen L, Esses SI. Changes in segmental intervertebral motion adjacent to cervical arthrodesis: a prospective study. Spine (Phila Pa 1976). 2004;29(11):E221-E226.

Taylor M, Hipp JA, Gertzbein SD, Gopinath S, Reitman CA. Observer agreement in assessing flexion-extension X-rays of the cervical spine, with and without the use of quantitative measurements of intervertebral motion. Spine J. 2007;7(6):654-658.

Zhao K, Yang C, Zhao C, An KN. Assessment of non-invasive intervertebral motion measurements in the lumbar spine. J Biomech. 2005;38(9):1943-1946.

Documentation

MMI Bibliography of Spine Imaging Studies

Download PDF

Lorem ipsum dolor sit amet consectetur.

Download PDF

Spine CAMP™ Instructions for Use

Download PDF

Let MMI provide insights into your clinical study imaging.

Have questions? We’ll connect you immediately to one of our scientific managers and imaging experts. Your time is precious, and we want to make the most out of it.

Spine

The MMI Advantage

Leading spine
imaging core lab

Gold standard QMA^® image analysis technology

Experienced with all types of spine therapies