Imaging techniques applicable to athletically induced cervical spine trauma

Abstract

Imaging is required after athletic trauma to the cervical spine to assess osseous and soft tissue integrity. The goal of the various imaging modalities is to obtain the maximum information without further compromising the neurological status or the life of the patient. The initial imaging modality is a cross-table lateral plain radiograph obtained without moving the head or cervical spine. On the routine lateral view the overall bony alignment and integrity of the osseous structures and the prevertebral soft tissues of the entire cervical spine are evaluated. The cervical spine must be braced to prevent motion before the patient is transferred to the radiographic, myelographic, computed tomogram (CT), or magnetic resonance imaging (MRI) table. A CT obtained after a myelogram is useful to evaluate the thecal sac, nerve roots and, indirectly, the cervical cord. MRI provides a myelographic effect without the need for a lumbar puncture and without ionizingradiation and provides direct visualization of the cervical cord and nerve roots. Additionally, MRI provides multiplanar visualization of the cervical spine, ie, sagittal, axial, and coronal images and, hence, is an ideal noninvasive imaging technique to evaluate the extent of cervical spine injury in the injured athlete.