Table of Contents

Cervical disc herniation diagnosis

see Cervical radiculopathy diagnosis.

Evaluation for myelopathy

Upper motor neuron findings usually in the lower extremities.

Weakness may occur without atrophy or fasciculations.

Spasticity: Poor control of the legs when walking, scissoring of the legs.

Sensation:

Any loss below the level of involvement will follow spinal cord patterns:

Complete loss

Brown Sequard pattern.

Central cord syndrome.

Pathologic reflexes: Hoffmann's reflex, Babinski sign, ankle clonus.

Magnetic resonance imaging

Cervical disc herniation Magnetic resonance imaging.

Computed tomography

CT requires less time to perform than MRI and is considered superior to MRI for evaluation of disc containment (e.g., bone) 1).

Multidetector row computed tomography (MDCT) and MRI showed a moderate-to-substantial degree of inter-modality agreement for the assessment of herniated cervical discs. MDCT images have a tendency to underestimate the anterior/posterior extent of the herniated disc compared with MRI 2).

Additionally, contrast-enhanced CT 3) and CT myelography 4) remain useful imaging tools in the evaluation of cervical radiculopathy, but they carry the risk of anaphylactic reactions and nephrotoxicity with the use of iodinated contrast material.

Electrodiagnosis

see Electrodiagnosis of cervical radiculopathy.

1) , 3)
Douglas-Akinwande AC, Rydberg J, Shah MV, Phillips MD, Caldemeyer KS, Lurito JT, et al. Accuracy of contrast-enhanced MDCT and MRI for identifying the severity and cause of neural foraminal stenosis in cervical radiculopathy: a prospective study. AJR Am J Roentgenol. 2010;194:55–61.
2)
Yi JS, Cha JG, Han JK, Kim HJ. Imaging of Herniated Discs of the Cervical Spine: Inter-Modality Differences between 64-Slice Multidetector CT and 1.5-T MRI. Korean J Radiol. 2015 Jul-Aug;16(4):881-8. doi: 10.3348/kjr.2015.16.4.881. Epub 2015 Jul 1. PubMed PMID: 26175589; PubMed Central PMCID: PMC4499554.
4)
Larsson EM, Holtås S, Cronqvist S, Brandt L. Comparison of myelography, CT myelography and magnetic resonance imaging in cervical spondylosis and disk herniation. Pre- and postoperative findings. Acta Radiol. 1989;30:233–239.