Objective: To correlate the findings on computed tomographic myelography (CTM) with surgically and pathologically proven prolapsed cervical disks, mention other pertinent cross-sectional imaging studies, and note the clinical relevance of certain CTM features.
Design: We retrospectively reviewed the medical and radiologic records of Mayo patients with suspected degenerative cervical disk disease during a 4-year period.
Material and methods: Between January 1986 and December 1989, 734 patients with possible cervical disk disease underwent assessment by CTM. An extruded disk was noted in 297 of these patients. In this study group, magnetic resonance (MR) imaging was also done in 28 patients and plain computed tomography was performed in 14, and we summarized those findings.
Results: Of the 297 study patients, 280 had a cervical radiculopathy and 17 had a myelopathy. CTM identified more than 90% of the extruded cervical disks. CTM could not distinguish between an osteophytic cartilaginous cap and a disk, and CTM could not identify the source of a cervical radiculopathy in 102 patients. Although only a few imaging studies other than CTM were performed, those modalities were less sensitive in the detection of prolapsed disks.
Conclusion: Imaging of cervical disk prolapse continues to be difficult, and the results are not always specific. CTM is the most sensitive imaging examination, but the number of MR studies in the current series of patients was insufficient for a reasonable comparison between the two modalities.