What is the gold standard for detecting disc herniations, spinal stenosis, and nerve root compression?

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MRI is the gold standard imaging modality for detecting disc herniations, spinal stenosis, and nerve root compression. Its strength is superior soft-tissue contrast, which lets you clearly see intervertebral discs, the thecal sac, nerve roots, and epidural spaces. With MRI you can identify disc protrusions or extrusions impinging on a nerve root, determine whether stenosis is central, foraminal, or in the lateral recess, and assess any associated edema or signal changes in neural structures. CT, while excellent for bony detail, doesn’t visualize soft tissues as well, and X-rays show mainly bone and alignment without addressing soft tissue pathology. Electromyography and nerve conduction studies evaluate nerve function rather than anatomical compression. So MRI provides the most complete, noninvasive view of the causes and extent of soft tissue neural compression.