MRI review by mail, or by secure upload

What the MRI review covers

Dr. McMillan personally reviews the submitted imaging and a brief clinical history. The review identifies what the imaging shows, whether the findings explain the patient’s symptoms, and whether one of the procedures offered at Synergy might address the issue.

The review isn’t a diagnosis-by-mail — it’s a screening step. A favorable review identifies the patient as a likely candidate worth further consultation. An unfavorable review candidly tells the patient that the issue isn’t appropriate for the procedures offered, often with suggestions about where to look next.

How to submit

Two paths: mail a copy of the imaging on disc to the office address, or upload through the secure portal accessible from /free-mri-review-start/. The intake form requests basic information about your symptoms, prior treatments tried, and any prior spine surgery.

Don’t send original imaging — always retain originals. The office reviews the copy and doesn’t return it; if you need to retrieve imaging later, you’ll go back to the imaging facility that performed the study.

What happens after submission

Review turnaround is typically within several business days. The office contacts you with the result by phone or secure messaging, depending on your preference. If you’re a likely candidate, the next step is phone consultation; if not, you’ll be told directly and given orientation about other options.

There’s no charge for the MRI review and no obligation. The point is screening — letting both sides assess fit before committing time or travel. Patients who proceed to consultation and procedure typically describe the MRI review step as efficient and worthwhile.

HIPAA and privacy

Submitted imaging and clinical information are protected health information (PHI) under HIPAA and handled accordingly. The office’s privacy practices govern collection, use, and storage. Patients can request the privacy notice in writing before submitting.

For secure electronic submission, the upload portal uses encryption and authenticated access. For mailed submissions, the imaging is handled by clinical staff and accessed only by Dr. McMillan and the small clinical team involved in your potential care. The submission itself doesn’t create a treating-physician relationship; consultation and explicit care decisions establish that.

Written bySteven Lockhart, Healthcare Marketing Group

Medically reviewed byMarion R. McMillan, MD, Interventional Pain Medicine & Endoscopic Spine Surgery

What to send

The MRI review requires the actual imaging — not just the radiologist’s written report. Reports describe what the radiologist saw, but Dr. McMillan personally reviews the imaging to confirm findings and identify surgical opportunities reports sometimes miss. Send imaging files on CD or DVD (most imaging centers provide one for free or a small fee), or upload through the secure portal at /free-mri-review-start/ as DICOM files. Include the radiologist’s report if you have it — helpful context but not a substitute for imaging. Process also at /free-mri-review/.

How to package and send

Mail to: Synergy Spine Center, 457-E Bypass 123, Seneca, SC 29678. Include a cover note with your name, date of birth, contact phone, contact email, brief symptom history, and what you’re hoping to learn. If you’ve been told you need fusion elsewhere, mention that explicitly with the recommending surgeon’s name and location — that context informs the review. USPS Priority Mail or any tracked courier works; tracking recommended.

What happens after you send the imaging

Imaging arrives at the office and is logged by the team. Dr. McMillan personally reviews each submission, typically within 3-5 business days (occasionally up to 7 during high-volume periods). You receive a written response with: (1) imaging read, (2) candidacy assessment, (3) specific procedure recommendation if applicable, (4) approximate bundled price, (5) suggested next steps. For non-candidates, the response includes referral guidance — often to a fusion surgeon when fusion is genuinely indicated. Full process context at /how-it-works/.

Security and privacy

All imaging submissions and communications are handled under standard HIPAA protections. Imaging is reviewed on secure office systems and is not shared with third parties. The federal framework is at HHS.gov — HIPAA. For submission questions, call (864) 886-9888 or (833) 770-8100.

What Dr. McMillan looks for during the review

The MRI review is not a checkbox exercise. Dr. McMillan reviews each submission looking for specific anatomical and clinical findings that determine surgical candidacy and procedure selection. For lumbar spine imaging, the primary evaluations include: disc pathology (herniation vs. bulge vs. protrusion vs. extrusion, and the specific location — central, paracentral, foraminal, extraforaminal); central canal stenosis (severity graded qualitatively based on cerebrospinal fluid space around the thecal sac); foraminal stenosis (severity graded based on nerve root visibility within the foramen); facet arthritis (severity and specific facet joints involved); alignment (spondylolisthesis grade if present, scoliosis if present); disc height loss (indicator of degenerative severity); and endplate changes (Modic changes suggesting active inflammation).

For cervical spine imaging, similar anatomical categories apply but with different clinical implications. Cervical stenosis has both central and foraminal components; cervical myelopathy (spinal cord compression producing cord signal changes) is a specific finding that shifts the surgical calculus significantly. Cervical disc herniation candidacy depends on the specific anatomical relationship to the nerve roots and cord. The endoscopic approach at the cervical spine is more limited than at the lumbar spine — some cervical patients are better served by a different procedural approach, and the review will identify this when applicable.

Beyond the anatomical findings, the review considers the symptom-imaging match. A patient with left leg pain in an L5 dermatomal pattern should have imaging findings that plausibly compress the L5 nerve root — either central at L4-5, foraminal at L5-S1, or a lateral recess narrowing. When symptoms and imaging don’t match, the review flags this as diagnostic ambiguity requiring additional workup (often diagnostic nerve blocks). Symptom-imaging mismatch is one of the most common reasons patients get told they need additional diagnostic workup before surgical commitment.

The written response you receive includes specific findings noted, the clinical significance of each finding, the recommended procedure if applicable, and the reasoning. Patients receiving the response are welcome to ask follow-up questions by phone or email; the office team routes technical questions back to Dr. McMillan for direct response. For patients who want to see their imaging discussed in more detail, the phone consultation covers the imaging in depth, and for patients who proceed to in-person visit, the imaging is reviewed together with the patient in the office on Day 1 of the 3-day plan.

Further reading and authoritative sources

The pages linked below cover related topics in more detail. For patients who prefer independent, non-practice sources, the external references at the end of the list provide authoritative verification of clinical facts, procedural information, and regulatory context. This practice’s clinical statements are traceable to the peer-reviewed literature and professional-society guidelines listed here.

Related pages on this site:

• Free MRI Review — details, indications, and process context relevant to the topic above.
• Start Free MRI Review — details, indications, and process context relevant to the topic above.
• How It Works — details, indications, and process context relevant to the topic above.
• 3-Day Plan — details, indications, and process context relevant to the topic above.
• Second Opinion Spine Surgery — details, indications, and process context relevant to the topic above.
• Contact — details, indications, and process context relevant to the topic above.

Independent authoritative sources:

• HHS — HIPAA Patient Privacy — authoritative independent source for verification and further reading.
• ACR Appropriateness Criteria — authoritative independent source for verification and further reading.

For patients whose questions extend beyond the material covered here, the direct path forward is the free MRI review for candidacy-specific questions or a phone call to (864) 886-9888 for process or logistics questions. The practice’s broader clinical philosophy — including the reasoning behind the no-fusion-first orientation and the single-surgeon model — is documented at /our-philosophy/.