Computed Tomography of the Spine

Abstract

Computed tomography (CT) and magnetic resonance imaging (MRI) have dramatically changed the way that diseases of the spine are diagnosed and treated. Indeed it is difficult to envision the practice of medicine without these advanced imaging techniques, although their widespread use spans only the last 25 yr. These modalities are best regarded as complementary, rather than as redundant, because each gives different and useful information. As an example, consider the evaluation of a patient with acute cervical spine trauma. Plain film radiography is generally the initial step in the evaluation of these patients. However, plain films are limited in their ability to detect nondisplaced fractures, to characterize complex fractures/dislocations optimally, or to evaluate fully injury at the cervicothoracic junction. In the severely injured patient, plain film evaluation is often hindered by difficulties with patient positioning and cooperation. Overlying material, such as a cervical collar or endotracheal tube, obscures bony detail and further limits the examination.