CT Cervical Spine Scans: What to Know

Medically Reviewed by Dan Brennan, MD on June 05, 2021

If you feel pain in your neck and shoulder, your doctor might want you to get a specific X-ray to see what’s causing the pain. This test is a computed tomography scan or what's more commonly called a CT scan. 

What Is a CT Cervical Spine Scan?

When you receive a doctor’s order for a medical test for your neck, you’ll see it written as a CT scan for the cervical spine. This is the top section of your spine that passes through your neck and ends at your brain. Issues with your cervical spine can cause:

  • Headaches
  • Dizziness
  • Pain in your neck, arms, shoulders, legs, and jaw
  • Numbness in your neck, hands, arms, and legs
  • Muscle spasms
  • Trouble with balance and walking
  • Loss of hand-eye coordination
  • Loss of bladder and bowel control

CT vs. MRI for Cervical Spine Scan

The CT scan is an advanced form of X-ray machine that uses computers to create images of your inner neck. These images show thin slices of your bones, blood vessels, and other structures, and together, they create a three-dimensional (3D) picture.‌

You might also hear about magnetic resonance imaging, or MRI. Instead of using X-rays, MRI scans use magnets and radio waves to create computer images of your inner neck. The MRI creates detailed 3D images right away.‌

CT scans are better for issues with your bones and blood vessels, while MRI scans are better for issues with your spinal cord, muscles, and other soft tissues. If your doctor orders a CT cervical spine scan, they may want a closer look at the bones or blood vessels in your neck. They may order an MRI as well. 

What Happens in a CT Cervical Spine Scan?

Your CT cervical spine scan begins with screening questions. A radiology nurse or technician will ask you about any allergies you may have and will review your medical history. Next, they’ll ask you to remove all jewelry and piercings. You may need to wear a hospital gown. ‌

If the doctor’s order requests contrast, you'll receive an injection at this point. You'll lie down on the CT table with your arms at your sides, and the technician will roll the table into the donut-shaped scanner. ‌

Once the scan begins, the machine sends out rotating X-ray beams to create the computerized images. You can expect the test to take about 10 to 15 minutes, but for some people, the CT scan may take up to 30 minutes. The radiology technician may ask you to hold your breath a few times to help avoid blurry images. Accidental movement is a common reason for unusable pictures.‌ 

CT Cervical Spine Scan Without Contrast. Cervical spine CT scans without contrast don’t have restrictions. You can eat and drink as usual before and after your test. 

CT Cervical Spine Scan With Contrast. Contrast is a type of dye that the radiology nurse injects into your arm. They administer the dye through your vein in a process called intravenous (IV) injection. This dye contains iodine that helps show differences between organs, bony structures, and other tissues in your body. The dye makes it easier for doctors to see what looks right and what doesn’t. 

For some people, this contrast dye can cause side effects like nausea, headaches, or itching. You may feel a brief salty or metallic taste in your mouth. Allergic reactions to this dye are not common, with studies showing that 88% to 99% of people have no reaction. 

You shouldn’t eat or drink anything for four to six hours before a CT scan that requires contrast. After your test, you should drink plenty of water to help your body get rid of the dye. ‌

If you have kidney disorders or take the diabetes medication metformin (Glucophage), your doctor may write an order for a CT cervical spine scan without contrast. People with certain medical conditions are more likely to get serious reactions to the dye. 

According to the American College of Radiology, contrast dye is safe for nursing mothers. Women can bottle-feed their infants for 24 hours following the test if they wish, but they can also safely breastfeed as usual. 

CT Cervical Spine Scans and Radiation Concerns

CT scans are noninvasive and aren’t expected to cause any negative long-term effects. While CT scans use radiation, the amount they use is quite small. According to the FDA and the American College of Radiology, the risks from radiation are much smaller than the benefit. 

When your doctor writes an order for a CT cervical spine scan with or without contrast, they’ve used their knowledge to make the decision. They feel that the benefit is far greater than the minor risks.

Next Steps

After your CT scan, the imaging radiologist reviews the images and includes notes for your doctor. Your doctor reviews the images and talks to you about the results, including whether you need any further testing. 

Show Sources


American College of Radiology: “ACR Manual on Contrast Media,” “ACR Statement on Recent Studies Regarding CT Scans and Increased Cancer Risk.”

Cedars Sinai: “CT Scan of the Cervical Spine.”

FDA: “Computed Tomography (CT).”

JOHNS HOPKINS Medicine: “Computed Tomography (CT or CAT) Scan of the Spine.”

Inside View UVAHealth: “MRI vs CT: What’s the Difference?”

International Journal of Angiology: “Adverse Reactions to Iodinated Contrast Media.” “Contrast Materials.”

UCSF Health: “Cervical spine CT scan.”

University of Miami Health System: “Cervical Spine Disorders.”

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