Functional Evaluation of the Spinal Cord by Magnetic Resonance Imaging in Patients with Rheumatoid Arthritis and Instability of Upper Cervical Spine

Anterior Atlantodental and Posterior Atlantodental Intervals on Plain Radiography, Multidetector CT, and MRI

“…AADI was measured from the posteroinferior aspect of the anterior arch of the atlas, to the adjacent anterior surface of despite several studies (21)(22)(23)(24). In the present work, we aimed to determine the normal values of AADI and PADI on plain radiography, MDCT and MRI, as well as the dural sac width and spinal cord diameter at the atlantoaxial joint level on MRI.…”

“…Dural sac width is known to vary with position. Dvorak et al (24) reported that in a patient group with known atlantoaxial instability, the mean diameter of the spinal cord was 7.4 mm in the neutral position and 6.5 mm in flexion, and that a spinal cord diameter, in cervical flexion, of less than 6 mm was a risk factor for neurological deficits. In the statistical analysis, the dural sac width most strongly correlated with PADI on MDCT.…”

Rheumatoid Arthritis of the Craniovertebral Junction: Surgical Strategies, Current Approach and Proposal of a New Therapeutic Algorithm

“…This is an important matter because, in addition to bone compression, the pannus reduces even further the available space for the cord within vertebral canal. Dvorak, et al [18] show that two thirds of rheumatoid patients with atlantoaxial subluxation have a pannus diameter over 3 mm (0.12 in), and recommend surgical treatment for those with Space Available for the Cord (SAC) < 6 mm. Basilar invagination may be measured in MRI through the Cervicobulbar Angle (CBA), which is measured by two lines tangent to the anterior faces of the bulb and cervical cord.…”

Columna cervical reumática

“…Se ha planteado también el uso de la RM dinámica en la evaluación de los pacientes. Dvorak et al reportó que los pacientes cuyo diámetro medular menor de 6mm en flexion estan en riesgo de déficit neurológico 16 . Sin embargo, debido a al riesgo teóricode muerte súbita en pacientes con inestabilidad severa, su uso rutinario es cuestionado 12 .…”

“…Dvorak et al reportó que los de C0 a C2. Las imágenes preoperatorias indican si la fusipacientes cuyo diámetro medular menor de 6mm en fleón debe ser prolongada hacia caudal, incluyendo todos los xion estan en riesgo de déficit neurológico 16 . Sin Segmentos subluxados.…”