Preoperative Diagnostics and Indication for Surgery

Abstract

Past medical history and clinical examination give information about radicular and myelopathic symptoms and help to assess the acuity of clinical complaints and thus the urgency of a possible surgical treatment. MRI is the imaging method of first choice in cases of degenerative diseases of the cervical spine with neurological symptoms. The meaning of pre- and postoperative functional X-ray imaging has continuously increased because of the growing number of dynamic implants for total disc replacement. With the help of CT scans especially bony driven stenoses of the cervical spinal canal can be diagnosed in detail. A myelogram is useful in selected cases of multilevel narrowing of the spinal canal, especially in cases of previous surgeries. If it is impossible to confirm or exclude the indication for surgery by means of clinical complaints and imaging findings, it might be useful to consider electrophysiological techniques for the clinical diagnosis.