Correlation between Magnetic Resonance Imaging and Radiographic Measurement of Cervical Spine in Cervical Myelopathic Patients

Wong, TM; Leung, HB; Wong, WC

doi:10.1177/230949900401200220

Cited by 32 publications

(48 citation statements)

References 9 publications

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“…The other upper limb clinical sign commonly found was upper limb hyper-reflexia (72%). These findings are similar to the ones reported by other authors [3,15]. The walking Romberg test was the second most prevalent clinical sign (see Table 1).…”

Section: Discussionsupporting

confidence: 82%

Does walking change the Romberg sign?

et al. 2009

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The Romberg sign helps demonstrate loss of postural control as a result of severely compromised proprioception. There is still no standard approach to applying the Romberg test in clinical neurology and the criteria for and interpretation of an abnormal result continue to be debated. The value of this sign and its adaptation when walking was evaluated. Detailed clinical examination of 50 consecutive patients of cervical myelopathy was performed prospectively. For the walking Romberg sign, patients were asked to walk 5 m with their eyes open. This was repeated with their eyes closed. Swaying, feeling of instability or inability to complete the walk with eyes closed was interpreted as a positive walking Romberg sign. This test was compared to common clinical signs to evaluate its relevance. Whilst the Hoffman's reflex (79%) was the most prevalent sign seen, the walking Romberg sign was actually present in 74.5% of the cases. The traditional Romberg test was positive in 17 cases and 16 of these had the walking Romberg positive as well. Another 21 patients had a positive walking Romberg test. Though not statistically significant, the mean 30 m walking times were slower in patients with traditional Romberg test than in those with positive walking Romberg test and fastest in those with neither of these tests positive. The combination of either Hoffman's reflex and/or walking Romberg was positive in 96% of patients. The walking Romberg sign is more useful than the traditional Romberg test as it shows evidence of a proprioceptive gait deficit in significantly more patients with cervical myelopathy than is found on conventional neurological examination. The combination of Hoffman's reflex and walking Romberg sign has a potential as useful screening tests to detect clinically significant cervical myelopathy.

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Section: Discussionsupporting

confidence: 82%

Does walking change the Romberg sign?

et al. 2009

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“…Além disso, observamos com maior frequência a estenose cervical no nível C5, conforme relatos prévios 3 . Apesar de sabidamente ser mais comum na raça oriental, devido maior ossificação do ligamento longitudinal posterior, que contribui para a estenose cervical 8 , em nosso estudo não havia nenhum paciente da raça oriental, possivelmente por nossa região ser de imigrantes de outras etnias.…”

Section: Discussionunclassified

“…Esse dado foi semelhante ao encontrado na literatura mundial que considera o Índice de Torg um método diagnóstico de estenose do canal cervical 3,8,11,[13][14][15][16][17][18][19][20] . O índice de Torg eliminou o viés da magnificação radiológica da medida direta do canal vertebral, o qual era causado por diferenças da distância entre o paciente, o filme e o tubo de raio-X.…”

Section: Discussionunclassified

“…Em nossa pesquisa, a radiografia demonstrou ser um bom método de diagnóstico e de screening de pacientes com MCE. Segundo Wong et al 8 , a radiografia faz parte da primeira linha de investigação devido sua acessibilidade, baixo custo operacional e habilidade em mostrar a ossificação do ligamento longitudinal posterior.…”

Section: Discussionunclassified

“…Há maior predisposição nos pacientes da raça Oriental 7,8 devido prevalente ossificação do ligamento longitudinal posterior, que contribui para um aumento da estenose.…”

Section: Introductionunclassified

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Comparação do Índice de Torg obtido por meio de radiografia e ressonância magnética nos pacientes com mielopatia cervical espondilótica

et al. 2012

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OBJETIVO: A Mielopatia Cervical Espondilótica (MCE) é uma disfunção da medula espinhal relacionada à degeneração típica do envelhecimento. No estudo de imagem podemos obter a medida do Índice de Torg, para estimar a estenose cervical. Objetivamos, assim, medir o Índice de Torg através de radiografia e ressonância magnética (RM), possibilitando verificar possíveis discrepâncias entre os métodos de medida. MÉTODOS: Realizada mensuração do Índice de Torg na radiografia e na RM da coluna cervical, sendo obtido através da relação entre a superfície posterior do corpo vertebral e o ponto mais próximo à linha laminar correspondente, dividido pelo diâmetro sagital do corpo vertebral. RESULTADOS: Participaram 29 pacientes, sendo 10 mulheres e 19 homens, com médias de idade 48,1 ± 11 anos, de peso 68,7 ± 5 Kg e de altura 1,68 ± 0,6 m. Houve diferença significativa entre o Índice de Torg calculado através de radiografia e RM, sendo menores os índices observados na RM (radiografia: 0,73 ± 0,17 vs. RM: 0,48 ± 0,14, p< 0,05). No entanto, ambas as aferições traduzem o mesmo resultado: estenose cervical absoluta (Índice de Torg < 0,8). CONCLUSÕES: Nossos resultados corroboram relatos de outros autores que acreditam que o Índice de Torg medido através da radiografia, como preconizado, minimiza a real estenose do canal cervical. Sugerimos em nosso estudo que a RM permite melhor estimativa do grau de estenose do canal, muito embora nossos resultados em relação ao grau de estenose cervical tenham sido semelhantes estatisticamente.

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Association between grip strength and walking pace with incidence of degenerative cervical myelopathy: a UK biobank observational study

Chengkai,

Junhong,

Zhengya

et al. 2024

Eur Spine J

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Correlation between Magnetic Resonance Imaging and Radiographic Measurement of Cervical Spine in Cervical Myelopathic Patients

Abstract: Cervical spine radiography cannot predict the level and degree of cervical spinal cord compression. Myelopathic hand signs are not diagnostically fail-safe and cannot predict the level and degree of cord compression.

Cited by 32 publications

References 9 publications

Does walking change the Romberg sign?

Does walking change the Romberg sign?

Comparação do Índice de Torg obtido por meio de radiografia e ressonância magnética nos pacientes com mielopatia cervical espondilótica

Association between grip strength and walking pace with incidence of degenerative cervical myelopathy: a UK biobank observational study

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