Advanced Imaging of the Spinal Cord: Quantitative, Functional, and Translational Approaches.

MR imaging of the human spinal cord presents unique challenges due to its small cross-sectional dimensions, complex microstructure, surrounding cerebrospinal fluid and other tissues, and susceptibility to motion and field inhomogeneities. Advanced imaging modalities have emerged to address these limitations by providing objective biomarkers of tissue integrity, metabolic status, and functional connectivity. This article synthesizes current evidence, outlines technical considerations and clinical applications of advanced spinal cord imaging, and provides a translational roadmap for integrating these modalities into research and clinical practice, ultimately aiming to improve diagnostic accuracy, prognostication, and patient-specific decision-making.