Diagnosis of cervical disc disease. MRI versus cervical myelography

In a prospective study of 63 surgical patients cervical myelography was compared with MRI to establish the relative value of the 2 diagnostic procedures in patient selection for surgery of ruptured cervical discs and bony nerve root compression. While MRI in the T1-weighted and gradient echo modes matched the diagnostic accuracy of invasive myelography (95%), T1 and T2-weighted MRI images alone were associated with an error rate of 10%. In patients with medial protrusion myelography did not always show the true extent of compression, whereas MRI tended to miss small laterally protruding disc fragments. Cervical myelography continues to have a place in the diagnosis of cervical disc disease, whenever clinical signs and symptoms do not agree with MRI data.