Imaging of the spine: Where do we stand?

Abstract

The number of patients presenting with spine-related problems has globally increased, with an enormous growing demand for the use of medical imaging to address this problem. The last three decades witnessed great leaps for diagnostic imaging modalities, including those exploited for imaging the spine. These developments improved our diagnostic capabilities in different spinal pathologies, especially with multi-detector computed tomography and magnetic resonance imaging, via both hardware and software improvisations. Nowadays, imaging may depict subtle spinal instability caused by various osseous and ligamentous failures, and could elucidate dynamic instabilities. Consequently, recent diagnostic modalities can discern clinically relevant spinal canal stenosis. Likewise, improvement in diagnostic imaging capabilities revolutionized our understanding of spinal degenerative diseases via quantitative biomarkers rather than mere subjective perspectives. Furthermore, prognostication of spinal cord injury has become feasible, and this is expected to be translated into better effective patient tailoring to management plans with better clinical outcomes. Meanwhile, our confidence in diagnosing spinal infections and assessing the different spinal instrumentation has greatly improved over the past few last decades. Overall, revolutions in diagnostic imaging over the past few decades have upgraded spinal imaging from simple subjective and qualitative indices into a more sophisticated yet precise era of objective metrics via deploying quantitative imaging biomarkers.

Differences in spinal posture and mobility between children/adolescents with obesity and age-matched normal-weight individuals

“…As the rolling wheels follow the spinous processes, data are sampled every 1.3 mm at a frequency of 150 Hz 20 – 22 . The validity of measuring segmental and global lumbar mobility using the Idiag M360 was determined in comparison with an X-ray examination, which, however, remains the gold standard for assessing spinal deformities 23 – 25 . Thoracic, lumbar and hip movement were measured in the sagittal and frontal plane when participants were asked to bend forward as far as they can into flexion followed by extension and lateral flexion from an upright standing position.…”

Standard reference values of the upper body posture in healthy male adults aged between 41 and 50 years in Germany

“…These primarily include clinical inspection and manual diagnostics by the orthopedic surgeon 7 . If, however, further information is necessary for therapy planning, the radiographic imaging examination is considered the gold standard despite its harmful side effects 8,9 . Due to radiation protection, however, the regular use of X-rays must be critically questioned with regard to low-risk initial diagnostics and possible follow-up after therapeutic measures 10 .…”

The use of separate‐level neuraxial anaesthesia for caesarean delivery in a patient with a history of spinal tuberculosis

“…Magnetic resonance imaging is the cross‐sectional imaging modality of choice in pregnancy as it avoids the doses of ionising radiation associated with computerised tomography. It is also the benchmark modality for evaluating both spinal degenerative disorders and spinal infections [6]. In our patient, it allowed us to identify the level of the lesion and assess the spinal cord and was therefore useful in planning the type and location of the neuraxial blocks.…”