Scoliosis deformity is a common spinal pathology in adolescents, and a significant portion of it can be corrected surgically. Preoperative knowledge of the spinal cord is essential, and in this regard even current multi-row CT and vertebrograms are difficult to achieve. MRI, especially three-dimensional imaging and its random surface image reorganization, can satisfy the need to understand the morphology of the spinal cord within the scoliotic spine and pave the way for a smooth surgery. The Department of Radiology of Zhongshan First Hospital Huangpu Campus has successfully performed dozens of cases of scoliosis with 3D MRI imaging and random surface image reconstruction by applying the Vista sequence, as shown in the attached figure. The operation procedure basically consists of doing continuous 3D scans of the cervical, thoracic, and lumbar segments first, which are stitched together and reconstructed into a 3D raw data set of the whole spine, followed by MPR or randomized curved MPR (RCMPR) conforming to the scoliosis alignment to accurately display the spinal cord morphology. Common spinal cord abnormalities, including abnormalities at the medulla oblongata-cervical cord junction, spinal cord cavities, spinal cord tumors, and spinal cord tethering syndrome, can be accurately visualized using these methods to adequately meet the preoperative evaluation requirements. These evaluations, which are not possible with 64-row CT or higher multi-row CT, are fundamentally due to the low soft tissue resolution of CT.