Title
Diagnostic-imaging algorithm for cervical soft disc herniation
Author
Faculty/Department
Faculty of Medicine and Health Sciences
Publication type
article
Publication
London ,
Subject
Human medicine
Source (journal)
Journal of neurology, neurosurgery and psychiatry. - London
Volume/pages
57(1994) :6 , p. 724-728
ISSN
0022-3050
ISI
A1994NP42500011
Carrier
E
Target language
English (eng)
Full text (Publishers DOI)
Affiliation
University of Antwerp
Abstract
MRI with surface coils is currently the preferred method for evaluating degenerative cervical spine disease. The differentiation between soft disc herniation and osteophytic spurs is not always obvious, however, on a 0.5 Tesla unit. The procedure of choice for soft disc herniation, MRI on a 0.5 T superconducting system associated with plain radiography of the cervical spine, in selecting patients for anterior cervical discectomy without interbody fusion (ACD), was evaluated. This prospective study comprised 100 patients with cervical radicular symptoms, not subsiding after conservative treatment. Plain radiographs were obtained for all patients. Patients without spinal instability, spondylosis, or major osteophytes on plain radiographs and without clinical findings of myelopathy underwent MRI (n = 59) on a 0.5 Tesla superconducting system. The other 41 patients underwent CT myelography. On MRI, herniation of a cervical soft disc was seen in 55 patients and the localisation corresponded well with the clinical symptoms. CT myelography showed a foraminal herniation in one of four selected patients with negative MRI. Fifty of 55 patients underwent ACD. All herniations were confirmed at operation, but in two patients there were important foraminal spurs not seen on MRI. It is concluded that 0.5 T MRI combined with plain radiographs offers an accurate, non-invasive test in the assessment of selected patients with cervical radiculopathy.
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