Although professional organizations agree patients with uncomplicated low back pain or radiculopathy without a red flag do not require imaging, investigators of recently published review discussed the utility of imaging for degenerative and infectious conditions of the spine.
Multidetector CT scans can be used to evaluate the integrity of osseous structures, disc herniation in the spinal canal and neural foramina, according to the review, while MRI is the primary form of imaging used to evaluate spinal pathology. Other modalities of imaging used for degenerative disc disease include diffusion-weighted imaging.
“Because the clinical diagnosis of spinal infection can be challenging owing vague symptoms of [low back pain] LBP or neck stiffness, radiological evaluations have gained importance in the diagnosis, treatment planning and treatment monitoring of the spinal infections,” the researchers wrote.
If a patient is suspected of having discitis-osteomyelitis, the researchers noted MRI be used to diagnose this condition as the modality has a greater soft tissue resolution. They noted that CT scans are reportedly good to assess the degree of osseous involvement and destruction. CT scans can detect osteopenia, soft tissue calcification, cortical bone erosion, permeative bone destruction and fragmentation ,and osseous sclerosis. According to researchers, a combination of spine gallium/technetium-99 bone scan may be used if an MRI cannot be performed.
Shah LM, et al. Neurosurgery. 2016; doi:10.1227/NEU.0000000000001323.
Disclosure: The researchers report no relevant financial disclosures.