Computed tomography of the spine: an update and review.

Computed tomography (CT) has proven to be an important diagnostic imaging technique for the evaluation of a variety of spinal disorders. The method is useful for identifying and characterizing acute fractures in traumatized patients and can accurately quantify spinal canal encroachment. Intervertebral disc disease and facet joint osteoarthritis are readily demonstrated by CT in both the cervical and lumbar regions. The technique can reliably distinguish between infection and neoplastic disease in the spine and is helpful for the guidance of percutaneous biopsy. A variety of congenital and developmental vertebral abnormalities, including dysraphic states, spondylolysis, and spinal stenosis, are optimally assessed using CT. Quantitative CT affords selective analysis of trabecular bone in the spine and has proven useful for the detection and follow-up of osteoporosis as well as other forms of metabolic bone disease. Most recently, the application of multiplanar reformation and three-dimensional image reconstruction has enhanced presentation of diagnostic information contained on cross-sectional images.