[The value of spinal CT in the planning of spinal surgery]

The diagnostic information gained by spinal CT for the planning of surgery of spinal disease is discussed under clinical aspects. For discogenic disease CT has replaced myelography in significance and as primary investigation, except for unclear complaints, that cannot be attributed to a specific segment. Here myelography still is the prime investigation. With CT degenerative peripheral appendages turned out to be significant for secondary stenosis syndromes of the spinal canal. In future it seems advisable, to differentiate between the facultatively pathogenetic important dorsal spondylosis and ventro-lateral spondylosis, which is unimportant for the spinal complaints. If surgical correction of congenital spinal malformations is considered, apparent or silent dysraphia must be ruled out in order to prevent neurological complications. Here CT can improve diagnostic safety significantly. For the resection of tumourous or inflammatory destructions CT provides an excellent means for preoperative statements on the necessary resection area, the size of the graft and the strength of adjacent soft tissues for the graft, the required stabilisation instruments, possible effects on adjacent organs, lumen reduction of the spinal canal, and the appropriate surgical entrance. The exploration of traumatic conditions of the spinal column by CT is of value especially for a detailed preoperative investigation, since it facilitates a quantification of the destruction of the vertebral body and the arches, the condition of the posterior body surface and the stenosis of the spinal canal.