Table 3.

Differential diagnosis table for cervical spondylolisthesis in the sagittal plane and appropriate imaging

Differential Diagnoses	Plain Radiography	Magnetic Resonance Imaging	Computed Tomography Myelography	Computed Tomography
Degenerative Cervical Spondylolisthesis	Upright, weight-bearing lateral cervical view is most appropriate for detecting anterior and posterior vertebral segmental translation. Lateral cervical flexion and extension views demonstrate changes in vertebral segmental translation during motion indicating cervical instability.	Most appropriate for imaging spinal stenosis or facet joint arthropathy. Provides a detailed view of the cervical spine, spinal canal, spinal cord, and soft tissue structures affected by spondylolisthesis.	Useful in assessing spinal stenosis or nerve roots and when MRI is contraindicated or inconclusive. Provides a view of the entire cervical spine and is done in the standing position (accentuates spinal stenosis).	Useful when MRI and CT myelography are contraindicated or inconclusive. Useful in assessing spinal stenosis or nerve roots and provides a detailed view of the facet joints.
Cervical Fracture	Upright, weight-bearing lateral cervical view is most appropriate for detecting anterior and posterior vertebral segmental translation Lateral cervical flexion and extension views demonstrate changes in vertebral segmental translation during motion indicating cervical instability. Oblique cervical views are most appropriate for detecting
Cervical Canal Stenosis		Most appropriate for imaging spinal stenosis. Provides a detailed view of the cervical spine, spinal canal, spinal cord, and soft tissue structures.	Useful in assessing spinal stenosis or nerve roots and when MRI is contraindicated or inconclusive. Provides a view of the entire cervical spine and is done in the standing position (accentuates spinal stenosis).	Useful when MRI and CT myelography are contraindicated or inconclusive. Useful in assessing spinal stenosis or nerve roots and provides a detailed view of the facet joints.
Cervical Disc Degeneration		Provides a detailed view of the cervical spine, spinal cord, and soft tissue structures, including the intervertebral discs and any degeneration.
Cervical Facet Dislocation	Upright, weight-bearing lateral cervical view is most appropriate for detecting anterior and posterior vertebral segmental translation and vertebral body and spinous process fractures. Anteroposterior views demonstrate cervical articular pillar fractures.
Cervical Facet Arthropathy		Most appropriate for imaging spinal stenosis or facet joint arthropathy. Provides a detailed view of the cervical spine, spinal cord, facet joints, and corresponding soft tissue structures.		Useful when MRI and CT myelography are contraindicated or inconclusive. Useful in assessing spinal stenosis or nerve roots and provides a detailed view of the facet joints.