{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T03:00:37Z","timestamp":1790391637780,"version":"4.1.0"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,14]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>MRI is a cornerstone of pediatric spinal evaluation but frequently requires sedation or general anesthesia in young children due to prolonged scan times. This use of anesthesia introduces periprocedural risks and logistical barriers that can delay care and increase burden for families. Fast-spine MRI (fsMRI) protocols offer a motion-tolerant, abbreviated alternative that may allow nonsedated imaging for selected pediatric indications. This study evaluates the clinical feasibility and operational impact of nonsedated fsMRI compared with routine pediatric spine MRI, with secondary analysis of institutional cost.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>All pediatric spine MR studies obtained between January 1, 2023, and December 31, 2024, at the authors\u2019 institution were retrospectively reviewed. Imaging protocol, scan duration, and patient age were recorded. Patients were stratified into younger (\u2264 6 years) and older (\u2265 7 years) cohorts. Financial data, including direct institutional cost, charge amount, payment received, and collection rate, were analyzed to assess economic impact.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 2358 pediatric spine MR images were included (643 fsMRI, 1715 routine MRI). Across all patients, fsMRI reduced the mean table time from 100.2 \u00b1 51.3 minutes to 34.6 \u00b1 12.5 minutes (p &lt; 0.0001). The time reduction was most pronounced in the younger cohort (105.9 \u00b1 54.8 minutes vs 35.7 \u00b1 12.7 minutes, p &lt; 0.0001). The mean direct institutional cost for fsMRI was $133.59 lower per scan ($284.12 vs $417.71), with a significantly higher collection rate (53.9% vs 47.4%, p = 0.0054).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Fast-spine MRI substantially reduces scan time, effectively removing the barrier of sedation for many young children. By serving as a rapid, nonsedated screening tool, this protocol offers a safer alternative to routine MRI that significantly expands appointment availability and improves access to care for all pediatric patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.3.peds2669","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:01:20Z","timestamp":1786492880000},"page":"1-8","source":"Crossref","is-referenced-by-count":0,"title":["Cost analysis of nonsedated fast-spine magnetic resonance imaging in pediatric patients"],"prefix":"10.3171","author":[{"given":"Parker","family":"Dhillon","sequence":"first","affiliation":[{"name":"Medical University of South Carolina College of Medicine, Charleston;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah L. A.","family":"Nawabi","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina College of Medicine, Charleston;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Hurst","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Lin","sequence":"additional","affiliation":[{"name":"Medical University of South Carolina College of Medicine, Charleston;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Somogyi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian F.","family":"Saway","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria V.","family":"Spampinato","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Science, Medical University of South Carolina, Charleston; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin","family":"Eskandari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of South Carolina, Charleston, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Neurosurg Focus","first-page":"E1","article-title":"Tethered cord syndrome: a review of the literature from embryology to adult presentation","volume":"29","author":"Hertzler DA","year":"2010","unstructured":"Hertzler DA, DePowell JJ, Stevenson CB, Mangano FT. Tethered cord syndrome: a review of the literature from embryology to adult presentation. Neurosurg Focus. 2010;29(1):E1. doi:10.3171\/2010.3.FOCUS1079"},{"issue":"21","key":"b2","series-title":"JAMA","first-page":"2312","article-title":"Association between a single general anesthesia exposure before age 36 months and neurocognitive outcomes in later childhood","volume":"315","author":"Sun LS","year":"2016","unstructured":"Sun LS, Li G, Miller TLK,  Association between a single general anesthesia exposure before age 36 months and neurocognitive outcomes in later childhood. JAMA. 2016;315(21):2312\u20132320. doi:10.1001\/jama.2016.6967"},{"issue":"1","key":"b3","series-title":"J Pediatr Gastroenterol Nutr","first-page":"3","article-title":"Sedation and the Food and Drug Administration warning: what a pediatric gastroenterologist, hepatologist, and pancreatologist should know","volume":"69","author":"Fishman DS","year":"2019","unstructured":"Fishman DS, Andropoulos DB, Lightdale JR. Sedation and the Food and Drug Administration warning: what a pediatric gastroenterologist, hepatologist, and pancreatologist should know. J Pediatr Gastroenterol Nutr. 2019;69(1):3\u20135. doi:10.1097\/MPG.0000000000002346"},{"issue":"3","key":"b4","series-title":"JAMA Netw Open","first-page":"e233875","article-title":"Factors associated with hospital commercial negotiated price for magnetic resonance imaging of brain","volume":"6","author":"Jiang JX","year":"2023","unstructured":"Jiang JX, Malhotra A, Bai G. Factors associated with hospital commercial negotiated price for magnetic resonance imaging of brain. JAMA Netw Open. 2023;6(3):e233875. doi:10.1001\/jamanetworkopen.2023.3875"},{"issue":"1","key":"b5","series-title":"J Am Coll Radiol","first-page":"18","article-title":"Out-of-pocket expenditures for imaging examinations: perspectives from national patient surveys over two decades","volume":"20","author":"Choksi EJ","year":"2023","unstructured":"Choksi EJ, Mukherjee K, Sadigh G, Duszak R. Out-of-pocket expenditures for imaging examinations: perspectives from national patient surveys over two decades. J Am Coll Radiol. 2023;20(1):18\u201328. doi:10.1016\/j.jacr.2022.07.014"},{"issue":"6","key":"b6","series-title":"J Neurosurg Pediatr","first-page":"676","article-title":"Use of fast-sequence spine MRI in pediatric patients","volume":"26","author":"Gewirtz JI","year":"2020","unstructured":"Gewirtz JI, Skidmore A, Smyth MD,  Use of fast-sequence spine MRI in pediatric patients. 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