Imaging current spine hardware: Part 1, cervical spine and fracture fixation

OBJECTIVE. The goals of this article are to review the indications for use, the materials, and the designs of hardware more commonly used in the cervical spine; to discuss alternatives for each of the different types of hardware; to review normal postoperative imaging findings; to describe the appropriateness of different imaging modalities for postoperative evaluation; and to illustrate examples of hardware complications. This article will also review vertebral body fracture fixation. CONCLUSION. Stabilization and fusion of the spine with intervertebral disk replacement, artificial ligaments, spinous process distraction devices, plate-and-rod systems, dynamic posterior fusion devices, and implants composed of new types of material are increasingly more common in the contemporary surgical practice. These spinal hardware devices will be seen more often in radiology practice. Successful postoperative radiologic evaluation of spinal hardware necessitates an understanding of the fundamental design of the hardware, the physiologic objective of the hardware, normal and abnormal postoperative imaging appearances, and complications unique to the hardware.