Recently, a single 3-D heavily T2-weighted fat-saturated sequence protocol has been shown to be a rapid, highly sensitive tool for evaluating CES in the emergency department that can be utilized for improved efficiency and emergency department throughput [42]. Although MRI lumbar spine without IV contrast is the preferred initial study, MRI lumbar spine without and with IV contrast may be helpful to delineate etiology of CES when underlying malignancy, infection, or inflammation is clinically suspected (see Variant 7). CT myelography of the lumbar spine assesses the patency of the spinal canal/thecal sac and of the subarticular recesses and neural foramen [22]. It can be useful for surgical planning in patients with CES and in patients with significant spinal stenosis on CT lumbar spine without IV contrast. Bone Scan Whole Body with SPECT or SPECT/CT Complete Spine There is no relevant literature to support the use of bone scan with SPECT or SPECT/CT in the initial imaging of suspected CES. CT Lumbar Spine With IV Contrast There is no relevant literature to support the use of CT with IV contrast in the initial imaging of suspected CES. CT Lumbar Spine Without and With IV Contrast There is no relevant literature to support the use of CT without and with IV contrast in the initial imaging of suspected CES. CT Myelography Lumbar Spine CT myelography of the lumbar spine assess the patency of the spinal canal/thecal sac and of the subarticular recesses and neural foramen [22]. It can be useful for surgical planning in patients with CES. This modality has the disadvantage of lumbar puncture and injection of intrathecal contrast [22]. Discography and Post-Discography CT Lumbar Spine There is no relevant literature to support the use of discography and post-discography CT lumbar spine in the initial imaging of suspected CES. FDG-PET/CT Whole Body There is no relevant literature to support the use of whole-body FDG-PET/CT in the initial imaging of suspected CES.
Low Back Pain PCAs. Recently, a single 3-D heavily T2-weighted fat-saturated sequence protocol has been shown to be a rapid, highly sensitive tool for evaluating CES in the emergency department that can be utilized for improved efficiency and emergency department throughput [42]. Although MRI lumbar spine without IV contrast is the preferred initial study, MRI lumbar spine without and with IV contrast may be helpful to delineate etiology of CES when underlying malignancy, infection, or inflammation is clinically suspected (see Variant 7). CT myelography of the lumbar spine assesses the patency of the spinal canal/thecal sac and of the subarticular recesses and neural foramen [22]. It can be useful for surgical planning in patients with CES and in patients with significant spinal stenosis on CT lumbar spine without IV contrast. Bone Scan Whole Body with SPECT or SPECT/CT Complete Spine There is no relevant literature to support the use of bone scan with SPECT or SPECT/CT in the initial imaging of suspected CES. CT Lumbar Spine With IV Contrast There is no relevant literature to support the use of CT with IV contrast in the initial imaging of suspected CES. CT Lumbar Spine Without and With IV Contrast There is no relevant literature to support the use of CT without and with IV contrast in the initial imaging of suspected CES. CT Myelography Lumbar Spine CT myelography of the lumbar spine assess the patency of the spinal canal/thecal sac and of the subarticular recesses and neural foramen [22]. It can be useful for surgical planning in patients with CES. This modality has the disadvantage of lumbar puncture and injection of intrathecal contrast [22]. Discography and Post-Discography CT Lumbar Spine There is no relevant literature to support the use of discography and post-discography CT lumbar spine in the initial imaging of suspected CES. FDG-PET/CT Whole Body There is no relevant literature to support the use of whole-body FDG-PET/CT in the initial imaging of suspected CES.