How is MRI used in the workup of cervical radiculopathy?

Updated: Oct 08, 2018
  • Author: Gerard A Malanga, MD; Chief Editor: Sherwin SW Ho, MD  more...
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  • MRI has become the method of choice for imaging the neck to detect significant soft-tissue pathology, such as disc herniation. The American College of Radiology recommends routine MRI as the most appropriate imaging study in patients with chronic neck pain who have neurologic signs or symptoms but normal radiographs. [24] MRI can detect ligament and disc disruption, which cannot be demonstrated by other imaging studies. The entire spinal cord, nerve roots, and axial skeleton can be visualized. This study is usually performed in the axial and sagittal planes.

  • MRI has been found to be quite useful in evaluating the amount of cerebrospinal fluid (CSF) surrounding the cord in the evaluation of patients with cervical canal stenosis, although the T2-weighted images tend to exaggerate the degree of stenosis. Cantu reviewed the use of MRI in the evaluation of athletes with possible cervical stenosis and noted that it can be quite helpful in determining the functional reserve of the spinal canal. [25]

  • Although MRI is considered the imaging method of choice for the evaluation of cervical radiculopathy, abnormalities have also been found in asymptomatic subjects. In one study, 10% of subjects younger than 40 years were noted to have disc herniations; of subjects older than 40 years, 20% had evidence of foraminal stenosis and 8% had disc protrusion or herniation. [26] Therefore, as with all imaging studies, the MRI findings must be used in conjunction with the patient's history and physical examination findings.

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