What is the role of imaging studies in the diagnosis of spinal cord injury (SCI)?

Updated: Nov 01, 2018
  • Author: Lawrence S Chin, MD, FACS; Chief Editor: Brian H Kopell, MD  more...
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Answer

Diagnostic imaging traditionally begins with the acquisition of standard radiographs of the affected region of the spine. Investigators have shown that computed tomography (CT) scanning is exquisitely sensitive for the detection of spinal fractures and is cost effective. [34, 35] In many centers, CT scanning has supplanted plain radiographs.

A properly performed lateral radiograph of the cervical spine that includes the C7-T1 junction can provide sufficient information to allow the multiple trauma victim to proceed emergently to the operating room if necessary without additional intervention other than maintenance of full spinal immobilization and a hard cervical collar.

Noncontiguous spinal fractures are defined as spinal fractures separated by at least 1 normal vertebra. Noncontiguous fractures are common and occur in 10-15% of patients with spinal cord injury. Therefore, once a spinal fracture is identified, the entire axial skeleton must be imaged, preferably by CT scanning, to assess for noncontiguous fractures. [31, 36, 37]


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