Neck (Cervical Spine) CT scan (without contrast)

What it is

The cervical spine is the column of seven vertebrae running from the base of the skull to the shoulders, with the spinal cord threaded through them. A CT of this region builds slices that a computer can stack into a three-dimensional model of the bones, seen from any angle. Bone is what CT does best, which is why this scan has largely replaced the neck x-ray for anyone who has taken a serious knock. Nothing is injected in this version: fractures, dislocations and the wear-and-tear changes of arthritis are all visible in the bone itself, and dye would not add to them.

Why it is done

• To rule out a fracture or a dislocation in someone who has been in a crash, taken a fall, or arrived with neck pain after an injury
• To look at bony narrowing around the nerve roots in someone with neck pain that travels down an arm
• To assess the spine before or after neck surgery, including whether hardware has settled where it should
• To examine the cervical spine in a patient who cannot have an MRI, since an implanted device is not a barrier to CT

What to expect

Patients lie flat on their back with the head held still, and are moved through the scanner while the tube rotates. Earrings, necklaces, hairpins and dental appliances are removed where possible because metal scatters x-rays and blurs the image. In trauma cases the scan is often done with a collar still in place and without moving the neck at all. Holding completely still is the only thing asked of the patient; the pictures are degraded by movement more than by anything else.

Questions worth asking

• Was this scan part of a trauma protocol that also imaged the head, chest or abdomen? Each region is its own code and its own charge.
• Was the study read by a radiologist at this hospital or sent to an outside teleradiology group? An out-of-network reader can generate a bill you did not choose.
• If a follow-up MRI of the neck is recommended, what does that cost here compared with the CT I already had?
• Can I get the images on a disc or through a portal, so a second opinion or a specialist visit does not mean paying to be scanned again?