Computed tomography (CT) and MRI are complementary imaging modalities for the evaluation of the traumatic spine. Osseous delineation is best assessed with CT, whereas MRI gives superb soft tissue description. Awareness of the strengths and pitfalls of each modality is critical in the accurate interpretation of images. Advances in MR imaging of the spine, particularly of the spinal cord, provide glimpses into to the pathobiological mechanism of spinal cord injury. Innovative techniques relay microstructural information about the integrity of the axons and myelin sheaths. In addition to clinical status, imaging features may be helpful in prognostication and in monitoring therapeutic interventions.
Key points
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Multidetector computed tomography (CT) is the first-line modality for the rapid evaluation of spinal trauma, with submillimeter axial acquisition and multiplanar reconstructions of the entire spine.
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MRI is complementary to CT in spine trauma evaluation, providing exquisite delineation of soft tissues, that is, ligamentous structures, spinal cord, and vessels.

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