Cervical Disc Protrusion

Preliminary Diagnosis: Cervical Disc Protrusion

I. What imaging technique is first-line for this diagnosis?

• Noncontrast extradural protocol MRI of the cervical spine in patients without a history of prior neck surgery

• In patients with prior neck surgery, the first-line for diagnosis is a contrast extradural protocol MRI of the cervical spine

II. Describe the advantages and disadvantages of this technique for diagnosis of cervical disc protrusion.

Advantages

• The patient is not exposed to ionizing radiation.

• Are able to differentiate granulation tissue from recurrent disc

Disadvantages

• Time consuming

• Requires significant patient cooperation to minimize motion artifact

• Expensive

III. What are the contraindications for the first-line imaging technique?

Patients who contain non-MR-compatible hardware

IV. What alternative imaging techniques are available?

CT myelography

V. Describe the advantages and disadvantages of the alternative techniques for diagnosis of cervical disc protrusion.

CT myelography

Advantages

• May be performed in patients with non-MR-compatible hardware

• May be performed much faster than MRI exams

Disadvantages

• Exposes the patient to ionizing radiation

• Invasive procedure with additional risks

VI. What are the contraindications for the alternative imaging techniques?

CT myelography

• Patients allergic to iodinated contrast

• Patients with renal failure

• Relative contraindication in pregnancy