CT Lumbar Spine With IV Contrast CT lumbar spine with IV contrast can be performed to evaluate osseous integrity (eg, pathologic fracture) when involved with tumor. However, intradural and spinal cord pathologies are poorly depicted on CT, so MRI without and with IV contrast is preferred. Addition of IV contrast may be useful to assess for epidural abscess in patients for this clinical scenario and for patients with suspected infection [45-47]. CT Lumbar Spine Without and With IV Contrast CT without and with IV contrast of the lumbar spine is not typically performed as there is no diagnostic advantage to performing a single study with or without IV contrast. Low Back Pain CT Lumbar Spine Without IV Contrast CT lumbar spine without IV contrast can be performed to evaluate osseous integrity (eg, pathologic fracture) when involved with tumor. However, intradural and spinal cord pathologies are poorly depicted on CT, so MRI without and with IV contrast is preferred. Addition of IV contrast may be useful to assess for epidural abscess in patients for this clinical scenario and for patients with suspected infection. [45-47]. CT Myelography Lumbar Spine 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 in patients with suspected neoplasm and neurologic deficit. 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 this clinical scenario. FDG-PET/CT Whole Body Whole-body FDG-PET/CT is typically not an initial imaging study but can be used to evaluate for widespread metastatic disease and can distinguish benign versus malignant compression fractures [65,66].
Low Back Pain PCAs. CT Lumbar Spine With IV Contrast CT lumbar spine with IV contrast can be performed to evaluate osseous integrity (eg, pathologic fracture) when involved with tumor. However, intradural and spinal cord pathologies are poorly depicted on CT, so MRI without and with IV contrast is preferred. Addition of IV contrast may be useful to assess for epidural abscess in patients for this clinical scenario and for patients with suspected infection [45-47]. CT Lumbar Spine Without and With IV Contrast CT without and with IV contrast of the lumbar spine is not typically performed as there is no diagnostic advantage to performing a single study with or without IV contrast. Low Back Pain CT Lumbar Spine Without IV Contrast CT lumbar spine without IV contrast can be performed to evaluate osseous integrity (eg, pathologic fracture) when involved with tumor. However, intradural and spinal cord pathologies are poorly depicted on CT, so MRI without and with IV contrast is preferred. Addition of IV contrast may be useful to assess for epidural abscess in patients for this clinical scenario and for patients with suspected infection. [45-47]. CT Myelography Lumbar Spine 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 in patients with suspected neoplasm and neurologic deficit. 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 this clinical scenario. FDG-PET/CT Whole Body Whole-body FDG-PET/CT is typically not an initial imaging study but can be used to evaluate for widespread metastatic disease and can distinguish benign versus malignant compression fractures [65,66].