Cervical stenosis, spondylosis, and herniated disc disease

Abstract

While IntCECT is still considered by many to be the optimal modality in cervical spine imaging, it is the most invasive of the techniques considered here. MR imaging may have nearly equivalent diagnostic capability in many cases of degenerative disc and spine disease. The value of unenhanced CT essentially is limited to the demonstration of bony changes. In the evaluation of radiculopathy, either MR imaging or IvCECT is useful for the initial screening and may be the only study needed. MR imaging is the study of choice for diseases of the spinal cord. With continuing progress in MR capability, IntCECT is shifting more toward a supplemental or confirmatory role. A rigid neurodiagnostic algorithm for this common radiologic problem is not possible. Rather, each step of the diagnostic process is influenced by the individual patient. Specific patient characteristics may affect the selection of an imaging modality. Modification of routine studies, such as use of gadolinium or oblique MR imaging, may be indicated in some patients. Finally, because of the high prevalence of asymptomatic disc and spine changes, knowledge of clinical findings is essential in the accurate interpretation of anatomic findings.