Introduction: The spine is usually imaged in the supine position, with basic projections showing mainly the anatomy of the individual spinal segments. However, to show the statics and mobility of the spine, we use an investigation called functional spinal imaging. Purpose: To define the usefulness of functional spinal imaging and compare it with other existing imaging methods through a systematic review of the literature on functional spinal imaging. Methods: A systematic literature review was carried out using articles that summarise the thesis topic, using a descriptive method. Results: Cervical and lumbar spine injuries can be diagnosed using static X-rays, functional imaging, computed tomography, magnetic resonance imaging or dynamic magnetic resonance imaging. The choice of imaging modality is based on its availability and urgency, and the type of injury. In functional imaging studies of the cervical spine, the likelihood of abnormal radiographs of flexion and extension is low in the case of normal static radiographs. They also mention the potential controversy of performing functional imaging of the neck in the acute state after trauma. Studies in the field of lumbar spine emphasize the advantages and disadvantages of individual diagnostic methods for diagnosing degenerative spondylolisthesis. Some studies question functional imaging, which has long been considered the gold standard. We conclude that functional imaging is of little diagnostic value compared to computed tomography and magnetic resonance imaging and that the performance of this type of imaging is strongly correlated with the time of performance. Discussion and conclusion: Functional imaging of the spine is based on the motion load on each part of the spine. The assessment includes an imaging of both the bone and connective structures of the spine. Most of the indications for this type of imaging are spinal instability in the cervical region and the slippage of a cranial vertebra relative to a caudal vertebra (spondylolisthesis) in the lumbar region. Research findings confirm the questionable contribution of functional imaging to the diagnosis due to muscle spasm immediately after injury and the low specificity and adequacy of flexion-extension radiographs. Due to all the shortcomings, in most cases it is used in combination with MRI and CT. However, a new technique called dynamic MRI has also been developed, which offers better visualisation of cervical spine motion and insight into dynamic changes in the spinal cord and neural structures.
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