Spine

76 topics with concise breakdowns: definitions, key facts, and classroom questions.

This section focuses on comprehensive imaging of the spine and spinal cord. It is based on a detailed review of normal anatomy and pathology using radiography, CT, MRI, SPECT, and spinal angiography.

The material covers all key clinical blocks. You will study degenerative diseases (from annulus fibrosus tears and disc herniations to Modic changes and stenosis), acute trauma (odontoid fractures, Chance fractures, Harborview criteria), and specifics of the postoperative spine, including the evaluation of transpedicular screws and postoperative hematomas. A dedicated block of articles covers neuroradiology: primary and secondary tumors (ependymomas, meningiomas, hemangiomas, metastases), as well as non-neoplastic and infectious spinal cord lesions (multiple sclerosis, transverse myelitis, tuberculosis).

Practical classes and exams most commonly require confident MRI interpretation for intervertebral disc herniations, knowledge of tumor classifications, the ability to rapidly identify unstable cervical spine injuries, and the differentiation of demyelinating processes (e.g., distinguishing multiple sclerosis from acute disseminated encephalomyelitis).

Section Topics

MRI of the thoracic spineMagnetic resonance imaging (MRI) is a highly informative imaging method Radiological anatomy of the spineColumna vertebralis Spinal cordMedulla spinalis Harborview criteriaThe Harborview criteria are a list of clinical and history-based signs Cervical spine radiographyCervical spine radiography is a baseline imaging tool Lumbar spine radiographyLumbar spine radiography is a baseline imaging method Spinal angiographySpinal angiography is a high-tech imaging method Spine CTComputed tomography (CT) of the spine is a modern imaging method Spine MRIMagnetic resonance imaging of the spine is a complex diagnostic Spine SPECTSingle-photon emission computed tomography (SPECT) is a non-invasive Lumbosacral spine MRIMagnetic resonance imaging is a key neuroimaging method Open-mouth radiographyOpen-mouth radiography is a specialized anteroposterior view Degenerative disc diseaseDegenerative disc disease encompasses a group of conditions Anulus fibrosus tearAnulus fibrosus Intervertebral disc herniationHernia disci intervertebralis Modic changesModic changes are MRI-detected pathological alterations in the Uncovertebral arthrosisArthrosis uncovertebralis SpondyloarthrosisSpondyloarthrosis Juxtafacet cystsJuxtafacet cysts are benign spinal formations Degenerative changes of spinal ligamentsLigamentum flavum SpondylolisthesisSpondylolisthesis Spinal stenosisStenosis canalis spinalis Degenerative scoliosisScoliosis Spinal and spinal cord tumorsDiagnostic imaging of spinal tumors relies on a comprehensive approach Giant cell tumor and aneurysmal bone cystOsteoclastoma MRI diagnosis of spinal tumorsMagnetic resonance imaging (MRI) is the key imaging modality for new Classification of spinal tumorsSpinal tumors are classified based on their location relative to the Spinal cord ependymomaEpendymoma Spinal cord astrocytomaAstrocytoma Spinal cord gangliogliomaGanglioglioma Vascular tumors and malformations of the spinal cordHaemangioblastoma Intradural extramedullary tumorsIntradural extramedullary tumors are neoplasms of the spinal Spinal meningiomaMeningioma Spinal nerve tumorsTumors of the spinal canal and nerve roots represent a hetero Spinal metastasesMetastatic spinal involvement occurs significantly more often than pri Vertebral hemangiomaHaemangioma Osteoid osteoma and osteoblastoma of the spineOsteoma osteoides Spinal chordomaChordoma Complications of spinal tumorsTumorous involvement of the spine is a severe pathology that often Spinal chondrosarcomaChondrosarcoma Spinal Ewing sarcomaEwing sarcoma is an aggressive malignant tumor capable of affecting Classification of spinal cord tumorsThe basic approach to systematizing neoplasms of the spine and spinal Non-neoplastic spinal cord lesionsNon-neoplastic spinal cord lesions represent a broad group Multiple sclerosis of the spinal cordSclerosis multiplex Acute disseminated encephalomyelitisEncephalomyelitis disseminata acuta Acute transverse myelitisMyelitis transversa acuta MRI semiotics of non-neoplastic spinal cord lesionsNon-neoplastic lesions of the spinal cord and peripheral nerves include Spinal sarcoidosisSarcoidosis Chronic inflammatory demyelinating polyneuropathyPolyneuropathia demyelinisans inflammatoria chronica Spinal dural arteriovenous fistulaA spinal dural arteriovenous fistula is a vascular pathology Infectious spinal cord lesionsInfectious spinal cord lesions include myelitis and bacterial abscesses Spinal tuberculosisTuberculosis ossium DiastematomyeliaDiastematomyelia Anterior spinal meningoceleMeningocele Intraspinal arachnoid cystsIntraspinal arachnoid cysts are intradural extramedullary SyringomyeliaSyringomyelia The postoperative spineDiagnostic imaging of the postoperative spine is essential for monitoring Surgical approaches to the spineSurgical approaches to the spine determine the optimal route to the lesion Pedicle screwsPedicle screws are components of spinal fixation systems designed Spinal epidural hematomaHaematoma epidurale PseudomeningocelePseudomeningocele Postoperative spinal changesDiagnostic imaging of postoperative spinal changes covers Spinal traumaSpinal trauma is a disruption of the structural integrity of the spinal Cervical spine traumaDiagnosis of cervical spine injuries is a key step in any serious C1-C2 rotatory subluxationC1-C2 rotatory subluxation is a pathological fixation of the vertebrae leading to Odontoid process fracture of C2A fracture of the C2 odontoid process is a severe injury of the cervical Hyperextension spinal traumaHyperextension spinal trauma occurs as a result of applied Chance fractureA Chance fracture (flexion-distraction injury) is a spinal injury Burst fracture of the spineA burst fracture of the spine is a type of injury characterized by Trauma to the ankylosing spineSpinal trauma in the setting of ankylosing spondylitis requires a total Post-traumatic syringomyeliaSyringomyelia Cervical spine MRIMagnetic resonance imaging of the cervical spine is a key imaging modality Cervical spine CTDiagnostic imaging (including CT, MRI, and radiography) of the cervical spine Cervicothoracic radiographyCervicothoracic radiography is a fast and accessible diagnostic method MRI of the cervical spine and brainMagnetic resonance imaging (MRI) serves as a key imaging modality Lumbar spine CTComputed tomography (CT) of the lumbar and thoracolumbar spine

Frequently asked questions for this section

Why is gadolinium contrast administration necessary after spinal surgery?

The routine protocol includes a sagittal short tau inversion recovery (STIR) sequence.

What is the anatomical difference between the anterior and posterior capsule of the facet joint?

Posterolaterally, the joint is covered by a dense multilayered fibrous capsule, whereas anteriorly the fibrous capsule is absent. Its role is performed by the ligamentum flavum and the synovial membrane.

At what level does the spinal cord terminate?

Normally, the terminal end of the spinal cord, or conus medullaris, is located at the level of the L1–L2 vertebrae.

Can radiography alone be sufficient in the presence of Harborview criteria?

No. The presence of even a single criterion indicates a high risk, in which case conventional radiography misses more than half of fractures. CT is required.

Why might the cervical lordosis appear straightened on a lateral radiograph?

Straightening of the cervical lordosis is often a consequence of the patient's upright position at the time of the scan and, in the absence of other symptoms, can be considered a physiological variant.

In what clinical scenarios is X-ray myelography ordered instead of MRI?

It is ordered when there are contraindications to MRI (e.g., cardiac pacemaker), severe claustrophobia, for dynamic assessment in spondylolisthesis, to search for cerebrospinal fluid leaks, or when metal artifact interference precludes adequate MRI evaluation.

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