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Thirty-eight patients with clinical indications of infectious, degenerative, and neoplastic disease underwent an MR imaging of the spine. The SyntAc sequence, with an acquisition time of 5 minutes 40 seconds, was added to the usual imaging protocol consisting of conventional sagittal T1 TSE, T2 TSE, and STIR TSE. The image quality was rated as “good” for both synthetic and conventional images. Interreader agreement concerning lesion conspicuity was good with a Cohen kappa of 0.737. The authors conclude that the study shows that synthetic MR imaging is feasible in spine imaging and produces, in general, good image quality and diagnostic confidence.