MRI Thoracic Spine Without and With IV Contrast MRI thoracic spine without and with IV contrast may be useful as an imaging study in patients with TBP and evidence of spinal deformity or osseous destruction on radiography, particularly if there is concern for infection or neoplasm [44]. MRI Thoracic Spine Without IV Contrast MRI without IV contrast may be useful in this setting to identify marrow replacing lesions, osseous destruction, canal compromise, and cord signal abnormality [27]. However, the addition of postcontrast sequences would be more sensitive in identifying thoracic spinal infection and its complications, assessing small marrow replacing lesions, and identifying intradural disease. Thoracic Back Pain Variant 7: Adult. Thoracic back pain without or with myelopathy or radiculopathy. Post thoracic spine surgery. Follow-up imaging. In patients with TBP and a history of spinal fixation, imaging plays an important role in assessing hardware position and integrity, assessing spinal alignment, assessing fusion, identifying findings suspicious for infection, and assessing for postoperative complications, including, but not limited to, postoperative collections, scarring, adjacent segment degeneration, and spinal deformity [47]. Several imaging modalities may be useful and complementary in the initial assessment of patients with TBP and a history of instrumented spinal fixation [43,45,47]. Bone Scan Whole Body There is no relevant literature to support the use of whole-body bone scans in the initial imaging assessment of this group. Bone Scan with SPECT or SPECT/CT Thoracic Spine There is limited literature to support the use of bone scan with SPECT or SPECT/CT thoracic spine in the initial imaging assessment of this group. CT Myelography Thoracic Spine CT myelography may also be helpful in patients in whom a compressive etiology of their symptoms is clinically suspected.
Thoracic Back Pain. MRI Thoracic Spine Without and With IV Contrast MRI thoracic spine without and with IV contrast may be useful as an imaging study in patients with TBP and evidence of spinal deformity or osseous destruction on radiography, particularly if there is concern for infection or neoplasm [44]. MRI Thoracic Spine Without IV Contrast MRI without IV contrast may be useful in this setting to identify marrow replacing lesions, osseous destruction, canal compromise, and cord signal abnormality [27]. However, the addition of postcontrast sequences would be more sensitive in identifying thoracic spinal infection and its complications, assessing small marrow replacing lesions, and identifying intradural disease. Thoracic Back Pain Variant 7: Adult. Thoracic back pain without or with myelopathy or radiculopathy. Post thoracic spine surgery. Follow-up imaging. In patients with TBP and a history of spinal fixation, imaging plays an important role in assessing hardware position and integrity, assessing spinal alignment, assessing fusion, identifying findings suspicious for infection, and assessing for postoperative complications, including, but not limited to, postoperative collections, scarring, adjacent segment degeneration, and spinal deformity [47]. Several imaging modalities may be useful and complementary in the initial assessment of patients with TBP and a history of instrumented spinal fixation [43,45,47]. Bone Scan Whole Body There is no relevant literature to support the use of whole-body bone scans in the initial imaging assessment of this group. Bone Scan with SPECT or SPECT/CT Thoracic Spine There is limited literature to support the use of bone scan with SPECT or SPECT/CT thoracic spine in the initial imaging assessment of this group. CT Myelography Thoracic Spine CT myelography may also be helpful in patients in whom a compressive etiology of their symptoms is clinically suspected.