A correlation of cervical magnetic resonance imaging and discography/computed tomographic discograms.

STUDY DESIGN: The morphology of sagittal T2-weighted magnetic resonance imaging (MRI) of the cervical spine was correlated with provocative discography and subsequent computed tomography (CT) discograms in 52 patients with discogenic pain.

OBJECTIVES: The authors determined if the morphology of cervical spine discs, as seen on MRI, correlates with discography/CT discograms in patients with discogenic pathology.

SUMMARY OF BACKGROUND DATA: Several studies have demonstrated a correlation between MRI and discography in the lumbar spine. No studies have attempted to show if this relationship exists in the cervical spine region.

METHODS: The morphology of cervical T2-weighted MRI was characterized with regard to the disc nuclear signal and posterior anulus status. Provocative discography was evaluated with regard to positive or negative responses. Computed tomography was performed after discography on each patient.

RESULTS: There was no correlation between pain response or morphology as seen on either discography or CT discography. A significant correlation was found between abnormality as seen on MRI and pain response on discography but the false-positive and false-negative rates were high.

CONCLUSION: Our results suggest that several MRI patterns correlate well with positive or negative cervical discography responses while several other patterns are equivocal. Magnetic resonance imaging is a useful adjunct to cervical discography but there are some MRI patterns that cannot be considered pathologic, and discography is required to diagnose discogenic pain syndrome.