MR imaging of traumatic spinal injuries

Plain films form the initial evaluation in all cases of spinal trauma. In cases of indeterminate or incomplete plain radiographs, further evaluation should be performed by multiplanar computed tomography (CT) and/or magnetic resonance imaging (MRI). Rapid triage is important to distinguish surgical and nonsurgical cases, as this has implications in terms of relief of cord compression and long-term prognosis. CT is unparalleled in its capacity to demonstrate bony abnormalities. MRI is the modality of choice in the evaluation of soft tissue injuries, in particular where there is a suspicion of ligamentous or intervertebral disc injury and spinal cord injury. MRI has the ability to distinguish between spinal cord edema and hemorrhage, which has important prognostic significance.