Disc osteophyte complex

A.Prof Frank Gaillard et al.

Disc osteophyte complex is a term used on MRI of the cervical spine to denote the presence of disc protrusion and/or marginal endplate osteophytes resulting in narrowing of the cervical canal. The term was introduced early in the practice of MRI as distinguishing between disc and osteophyte can be difficult or impossible on T2 weighted images. 

Thin gradient echo images are however often able to distinguish between disc (which is relatively bright) and osteophyte (which is dark) and in such cases it has been argued that using the term should be avoided, as the distinction is of surgical importance 1

Others have suggested that the term is useful in so far as it is difficult when faced with a dark band of tissue extending along the posterior aspect of the disc to distinguish between various components of disc degeneration (marginal osteophyte, bulging annular fibres, disc herniation, and ossification of posterior longitudinal ligament) 2.  In other words, when high T2 disc herniation is not visualised then it is uncertain what contributes to the disc-osteophyte-complex. 

A reasonable middle ground is to not use the term disc osteophyte complex for all disc pathologies in the cervical spine (this is lazy and does not communicate important information to the referring clinicians), but to reserve use for cases where the underlying pathology is truly unclear. 

Importantly, the term should never be used in the lumbar spine, nor should it be used to describe uncovertebral osteophytic narrowing of neural exit foramina 2

 

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