The problem of inflammatory myelitis is increasing, making CSF tap and analysis critical in assessing cervical neurologic disease. Even when other neurologic conditions are identified, myelitis may be present. Unfortunately, many patients are treated with corticosteroids before being adequately worked-up for cervical disease. The work-up performed in the face of the steroids may be erroneous. As such, surgical intervention may be performed, only later to discover the cause of neck pain was inflammatory meningomyelitis.
Spinal myelography helps to contrast the spinal cord when looking for mass lesions.
It can be an extremely valuable diagnostic aid in determining the need for surgical intervention and what surgical approach is best. In cervical vertebral malformation complex, the lesion is dynamic. The only imaging technique which can provide dynamic views is the myelogram. Myelography, therefore, remains the single most important imaging technique for assessing surgical diseases in the cervical spine. When the myelographic data is lacking or when it is not clear what the lesion represents, MRI can add diagnostic detail.