Diagnostic capabilities of magnetic resonance imaging and computed tomography in acute cervical spinal column injury

The present study was conducted to evaluate the imaging capabilities of magnetic resonance imaging (MRI) in evaluating acute cervical spinal column injury and compare these results to that of computed tomographic (CT) imaging. Forty-nine patients undergoing MRI at a Level I and regional spinal cord trauma center to evaluate cervical spinal column injury were studied. Seventy-one injuries were identified by MRI. These injuries were classified as osseous (fracture/dislocation) (n = 21), disc herniation (n = 29), and spinal cord injury (edema/contusion/transection) (n = 21). Diagnostic imaging results in 33 of the 49 patients undergoing both MRI and CT were compared. CT demonstrated 22 fracture/dislocations compared to 10 on MRI. MRI demonstrated 19 disc protrusions compared to 7 on CT. Additionally, MR imaged 13 cord injuries as compared to 0 by CT. MR imaging proved superior in demonstrating spinal cord pathology and intervertebral disc herniation. CT was superior to MRI in demonstrating osseous injury. CT and MRI may be useful together in determining presence and extent of spinal column injury.