Cite

Copy

Tap on and choose 'Add to Home Screen' to create a shortcut app

Tap on and choose 'Install/Install App' to create a shortcut app

Imaging of the Spines of Children

This page was last updated on June 10th, 2018

Author

Dawn Saunders, M.D.

Section Editors

Doug Brockmeyer, M.D.

Dominic Thompson, M.D.

Editor in Chief

Rick Abbott, M.D.

Introduction

The three most commonly used imaging modalities applied to the spine are plain x-rays, CT, and MRI. The choice of imaging technique depends on the clinically suspected site of pathology, the clinical questions being posed, as well as the techniques that are readily available to the clinician. More than one imaging technique may be required as a single patient may have multiple pathologies, e.g., a child with a scoliosis may have a vertebral anomaly such as a hemivertebrae detected on a CT and an associated diastematomyelia diagnosed on MRI.

Key Points

  • Vertebral column integrity: Plain films and CT scanning are most useful for the imaging of the vertebral column including both the integrity of the vertebrae and discs and the alignment, e.g., in trauma or deformity. Fine-cut axial CT imaging of the spine can be useful in evaluating suitability for instrumentation.
  • Neurological dysfunction: MRI is the imaging modality of choice in children with neurological dysfunction or where it might be anticipated that skeletal disease or deformity is compromising the spinal cord or cervicomedullary junction. MRI can be replaced by spiral CT with multiplanar reformats, following the injection of intrathecal contrast, if MRI is not available.
  •  Neonatal spine: Ultrasound can be used as a screening test to detect spinal pathology in the neonate and young infant in whom the posterior elements have not ossified.
  • Atlanto-axial instability: Dynamic imaging is usually performed using plain films to assess, e.g., the stability of the atlantoaxial joint, but in other situations, dynamic CT is required, e.g., in patients with atlantoaxial rotatory fixation.
  •  Infection: In the absence of the availability of MRI, nuclear medicine techniques may be used with plain film or CT scanning in the investigation of a child with suspected infection, e.g., discitis.

Your donations keep us going

The ISPN Guide is free to use, but we rely on donations to fund our ongoing work and to maintain more than a thousand pages of information created to disseminate the most up-to-date knowledge in the field of paediatric neurosurgery.

By making a donation to The ISPN Guide you are also indirectly helping the many thousands of children around the world whose treatment depends on well-informed surgeons.

Please consider making a donation today.

Use the app

The ISPN Guide can be used as a standalone app, both on mobile devices and desktop computers. It’s quick and easy to use.

Fully featured

Free registration grants you full access to The Guide and host of featured designed to help further your own education.

Stay updated

The ISPN Guide continues to expand both in breadth and depth. Join our mailing list to stay up-to-date with our progress.