Which imaging technique is best for evaluating disc herniation?

The most effective imaging technique for evaluating disc herniation is a myelogram. This procedure involves the injection of a contrast dye into the spinal canal, followed by imaging typically using X-rays or CT scans. The contrast material enhances the visibility of the spinal cord, nerve roots, and intervertebral discs, allowing for a clearer identification of any herniated discs and their impact on the surrounding neural structures.

Myelography is particularly useful in cases where MRI is contraindicated or when additional imaging detail is needed to assess nerve root involvement or other complications associated with disc herniation. It provides more detailed information about the anatomy and any structural disruptions compared to standard imaging techniques.

In contrast, standard X-rays only provide a view of bone structures and can miss soft tissue abnormalities such as disc herniations. A CT scan, although better than X-rays for visualizing softer tissues, can still fall short of providing comprehensive details compared to a myelogram, especially in detecting the extent of nerve root compression. Ultrasound is not typically effective for evaluating spinal issues like disc herniation due to its limitations in penetrating depth and resolution for structures within the spine.