CT Diagnosis of Cervical Hernias

Abstract

With the advent of high-resolution CT-scanners the diagnosis of cervical disc herniation can easily be made without intrathecal injection of contrast. A localizing CT “Scoutview” or “Topogram” is at first obtained for proper siting of the CT slices to the cervical region of interest. In the study of cervical pathology the use of thin slices (2 or 4 mm) is necessary and the images obtained should be electronically enlarged to permit adequate delineation of pathology. The examination should not be limited to the intervertebral disc space only, but should also be extended upwards and downwards as migration of hernias is known to occur in both directions. In order to obtain optimal hard copies of CT images a narrow window with a low center level should be used for optimal visualization of relatively low density disc fragments. In some instances CT demonstration of a hernia may be improved by utilizing a high-lighting computer program. As a matter of fact the CT density of hernias varies according to its structural components: disc material, calcifications, associated bone avulsions or degenerative changes including necrosis and gas formation [1–5].