Compare the utility of CTmyelography and MRI for assessment of cervical stenosis presenting with myelopathy

After plain radiographs are obtained, MRI is usually the next test obtained in the imaging workup for cervical myelopathy. MRI provides a noninvasive means of visualizing the entire cervical spine, including the discs, vertebra, spinal cord, and nerve roots, in multiple planes. CT-myelography plays a role when MRI is contraindicated or when osseous pathology contributes to spinal canal encroachment. In the presence of complex cervical stenosis problems, CT-myelography continues to play a significant role, especially in patients with ossification of the posterior longitudinal ligament (OPLL) where progressive mineralization of this ligament progressively narrows the diameter of the cervical spinal canal (Fig. 12-4A, B). CT images are also valuable in preoperative planning of complex spinal instrumentation procedures for assessment of potential screw fixation sites and their relationship to osseous abnormalities and critical vascular structures (e.g. vertebral artery).

Figure 12-4. Ossification of the posterior longitudinal ligament (OPLL), cervical stenosis, and cervical myelopathy. Sagittal image (A) and axial image (B) depict continuous OPLL (straight arrows). Double layer sign (curved arrows) is pathognomonic for an absent dural plane and risk of cerebrospinal fluid fistula. (From Epstein NE. From the imaging department. Spine Journal 2001 ;1:77, with permission.)

Figure 12-4. Ossification of the posterior longitudinal ligament (OPLL), cervical stenosis, and cervical myelopathy. Sagittal image (A) and axial image (B) depict continuous OPLL (straight arrows). Double layer sign (curved arrows) is pathognomonic for an absent dural plane and risk of cerebrospinal fluid fistula. (From Epstein NE. From the imaging department. Spine Journal 2001 ;1:77, with permission.)

How To Win Your War Against Back Pain

How To Win Your War Against Back Pain

Knowing the causes of back pain is winning half the battle against it. The 127-page eBook, How To Win Your War Against Back Pain, explains the various causes of back pain in a simple manner and teaches you the various treatment options available. The book is a great pain reliever in itself. The sensible, practical tips that it presents will surely help you bid good-bye to back pain forever.

Get My Free Ebook


Post a comment