Imaging of the Cervical Spine

Abstract

The emergence of multiplanar spiral computed tomography and high-resolution magnetic resonance imaging has resulted in the ability to see cervical spine anatomy and pathologic conditions in detail. Appropriately chosen and performed, these imaging studies can provide an anatomic basis for a clinical diagnosis and a therapeutic plan. In the evaluation of cervical spondylosis, magnetic resonance imaging is more commonly performed than computed tomography because of its superior depiction of soft tissue anatomy, including intervertebral discs and spinal cord disease. However, computed tomography still has a role, particularly in the assessment of osseous neural foraminal stenosis. In cervical spine trauma, routine radiography remains the procedure of choice. Computed tomography is performed in patients who have abnormal plain radiographs or in patients in whom there is a strong clinical suspicion of fracture with inconclusive radiographs. In the neurologically compromised patient, magnetic resonance imaging is useful in the diagnosis of cord and nerve root injury. Magnetic resonance imaging is the most sensitive and specific imaging study in the assessment of spinal infection, including osteomyelitis, discitis, and epidural abscess. Magnetic resonance imaging has also supplanted all other imaging methods in the evaluation of primary and secondary tumors of the spinal cord and spinal column. Despite the precise depiction of cervical spine anatomy provided by these imaging methods, the role of the clinician in determining the true cause of a patient's symptoms is in no way diminished. The presence of an imaging study abnormality does not automatically imply causality.

Treatment of cervical myelopathy in patients with the fibromyalgia syndrome: outcomes and implications

“…These advantages include better resolution of bony anatomy and lack of exaggeration of spinal canal stenosis [19-21, 35, 37, 41]. In addition, dynamic imaging of the spine in the axial plane using MRI has certain shortcomings; sagittal images (which are inferior to axial images for the assessment of stenosis) are almost exclusively used [21,31,32]. These shortcomings relate to the relationship between the extended or flexed neck and the surface magnetic coils, and are avoided by using CT technology [21,32].…”

Clinical evidence for cervical myelopathy due to Chiari malformation and spinal stenosis in a non-randomized group of patients with the diagnosis of fibromyalgia

“…These advantages include better resolution of bony anatomy and lack of exaggeration of spinal canal stenosis [28,29,30,43,44,51]. In addition, dynamic imaging of the spine in the axial plane using MRI has certain shortcomings; sagittal images (which are inferior to axial images for the assessment of stenosis), are almost exclusively used [30,40,41]. These shortcomings, related to the relationship between the extended or flexed neck and the surface magnetic coils, are avoided by using CT technology [30,41].…”

“…In addition, dynamic imaging of the spine in the axial plane using MRI has certain shortcomings; sagittal images (which are inferior to axial images for the assessment of stenosis), are almost exclusively used [30,40,41]. These shortcomings, related to the relationship between the extended or flexed neck and the surface magnetic coils, are avoided by using CT technology [30,41]. Conversely, CT is inferior to MRI for imaging the spinal cord itself [30].…”

“…These shortcomings, related to the relationship between the extended or flexed neck and the surface magnetic coils, are avoided by using CT technology [30,41]. Conversely, CT is inferior to MRI for imaging the spinal cord itself [30]. The use of CT with intravenous contrast enhancement for the purpose of imaging cervical disc herniation or stenosis has been previously described [28,29,30,35,44,48,51].…”

“…Conversely, CT is inferior to MRI for imaging the spinal cord itself [30]. The use of CT with intravenous contrast enhancement for the purpose of imaging cervical disc herniation or stenosis has been previously described [28,29,30,35,44,48,51].…”