Imaging

Cervical Disc Protrusion

Preliminary Diagnosis: Cervical Disc Protrusion

I. What imaging technique is first-line for this diagnosis?

  • Noncontrast extradural protocol MRI of the cervical spine in patients without a history of prior neck surgery

  • In patients with prior neck surgery, the first-line for diagnosis is a contrast extradural protocol MRI of the cervical spine

II. Describe the advantages and disadvantages of this technique for diagnosis of cervical disc protrusion.

Advantages

  • The patient is not exposed to ionizing radiation.

  • Are able to differentiate granulation tissue from recurrent disc

Disadvantages

  • Time consuming

  • Requires significant patient cooperation to minimize motion artifact

  • Expensive

III. What are the contraindications for the first-line imaging technique?

Patients who contain non-MR-compatible hardware

IV. What alternative imaging techniques are available?

CT myelography

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of cervical disc protrusion.

CT myelography

Advantages

  • May be performed in patients with non-MR-compatible hardware

  • May be performed much faster than MRI exams

Disadvantages

  • Exposes the patient to ionizing radiation

  • Invasive procedure with additional risks

VI. What are the contraindications for the alternative imaging techniques?

CT myelography

  • Patients allergic to iodinated contrast

  • Patients with renal failure

  • Relative contraindication in pregnancy

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