Which imaging modality best visualizes spinal cord compression and soft tissue in suspected cervical myelopathy?

• A. CT scan of the neck
• B. MRI of the cervical spine
• C. X-ray of the cervical spine
• D. Ultrasound of the neck

Answer: (B)

To understand cervical myelopathy, you need an imaging study that shows the spinal cord and the surrounding soft tissues clearly. MRI of the cervical spine provides superior soft-tissue contrast and multiplanar views, so it can precisely reveal where the spinal cord is being compressed and identify contributing soft-tissue problems like disc herniation, ligament thickening, or ossified ligaments. It can also show intramedullary changes in the cord, such as edema or myelopathy, which helps confirm the diagnosis and guide treatment.

CT scans are excellent for bone detail and calcifications, but they don’t visualize the spinal cord or soft tissues as well as MRI. X-rays can screen for alignment and gross degenerative changes but miss the soft-tissue pathology causing compression. Ultrasound isn’t suitable for evaluating the spinal canal or spinal cord.

Therefore, MRI of the cervical spine is the best choice for visualizing spinal cord compression and soft tissue in suspected cervical myelopathy.