Normal Cervical Spine Morphometry and Cervical Spinal Stenosis in Asymptomatic Professional Football Players

Herzog, Richard J.; Wiens, Jeryl J.; Dillingham, Michael F.; Sontag, Mark J.

doi:10.1097/00007632-199106001-00001

Cited by 214 publications

(91 citation statements)

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“…These advantages include better resolution of bony anatomy and lack of exaggeration of spinal canal stenosis [28,29,30,43,44,51]. In addition, dynamic imaging of the spine in the axial plane using MRI has certain shortcomings; sagittal images (which are inferior to axial images for the assessment of stenosis), are almost exclusively used [30,40,41].…”

Section: Discussionmentioning

confidence: 99%

“…Conversely, CT is inferior to MRI for imaging the spinal cord itself [30]. The use of CT with intravenous contrast enhancement for the purpose of imaging cervical disc herniation or stenosis has been previously described [28,29,30,35,44,48,51].…”

Section: Discussionmentioning

confidence: 99%

“…2). A midsagittal diameter of 10 mm is acknowledged as stenotic and consistent with symptomatic spinal cord compression, i.e., cervical myelopathy [11,20,27,28,35,48,50]. In fact, Stanley et al concluded that 10 mm must be considered the lower limit of normal for the AP mid-sagittal diameter of the cervical spine, as imaged by CT scan.…”

Section: Discussionmentioning

confidence: 99%

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Clinical evidence for cervical myelopathy due to Chiari malformation and spinal stenosis in a non-randomized group of patients with the diagnosis of fibromyalgia

et al. 2004

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Clinical evidence for cervical myelopathy due to Chiari malformation and spinal stenosis in a non-randomized group of patients with the diagnosis of fibromyalgia

et al. 2004

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“…We defined the sagittal diameter of the CSF column at a given pedicle level as the sagittal cervical canal diameter [10][11][12][13]. The sagittal diameter of the spinal cord is nearly constant in adults, averaging approximately 8 mm from C3 to C7 [14].…”

Section: Measurement Of Sagittal Diameter Of Csf Columnmentioning

confidence: 99%

Clinical relationship between cervical spinal canal stenosis and traumatic cervical spinal cord injury without major fracture or dislocation

et al. 2013

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Purpose The purpose of the study was to evaluate the clinical relationship between cervical spinal canal stenosis (CSCS) and incidence of traumatic cervical spinal cord injury (CSCI) without major fracture or dislocation, and to discuss the clinical management of traumatic CSCI. Methods Forty-seven patients with traumatic CSCI without major fracture or dislocation (30 out of 47 subjects; 63.83 %, had an injury at the C3-4 segment) and 607 healthy volunteers were measured the sagittal cerebrospinal fluid (CSF) column diameter at five pedicle and five intervertebral disc levels using T2-weighted midsagittal magnetic resonance imaging. We defined the sagittal CSF column diameter of less than 8 mm as CSCS based on the previous paper. We evaluated the relative and absolute risks for the incidence of traumatic CSCI related with CSCS. Results Using data from the Spinal Injury Network of Fukuoka, Japan, the relative risk for the incidence of traumatic CSCI at the C3-4 segment with CSCS was calculated as 124.5:1. Moreover, the absolute risk for the incidence of traumatic CSCI at the C3-4 segment with CSCS was calculated as 0.00017. ConclusionsIn our results, the relative risk for the incidence of traumatic CSCI with CSCS was 124.5 times higher than that for the incidence without CSCS. However, only 0.017 % of subjects with CSCS may be able to avoid developing traumatic CSCI if they undergo decompression surgery before trauma. Our results suggest that prophylactic surgical management for CSCS might not significantly affect the incidence of traumatic CSCI.

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“…However, the low positive predictive value of the TPR represents a major disadvantage. 2,7,13,18 Spondylotic changes, which most commonly occur in the vicinity of the intervertebral disc, and canal narrowing caused by soft tissue cannot be assessed with the TPR. 6,20 There is evidence that MRI parameters are more suitable for the evaluation of cervical spinal canal stenosis.…”

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The diagnostic value of magnetic resonance imaging measurements for assessing cervical spinal canal stenosis

Rüegg

Wicki

Aebli

et al. 2015

SPI

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OBJECT The authors investigated the relevance of 2D MRI measurements for the diagnosis of critical cervical spinal canal stenosis. Among patients who had sustained a minor cervical spine trauma, they compared MRI measurements of the cervical spine between those with acute cervical spinal cord injury (CSCI) and those without. They also investigated the correlation between the MRI measurements and the severity of CSCI as well as classification accuracy concerning the diagnosis of critical spinal canal stenosis for acute CSCI after a minor trauma. METHODS The authors conducted a single-center retrospective radiological case-control study of patients who had sustained CSCI after a minor trauma to the cervical spine from January 2000 to August 2010. The controls were patients who had sustained a cervical trauma without clinical or radiological signs of cervical spinal cord pathology. On axial T2-weighted MR images, the following were measured: the transverse spinal canal and cord area, the transverse and sagittal cord diameter, and the sagittal canal diameter of the cervical spine (C3–7). Using these measurements, the authors calculated the cord-canal-area ratio by dividing the transverse cord area by the transverse canal area, the space available for the cord by subtracting the sagittal canal diameter from the sagittal cord diameter, and the compression ratio by dividing the transverse cord diameter by its sagittal diameter. The severity of CSCI was assessed by using the motor index scores of 10 key muscles at different time points (initially, 1, 3, and 12 months after injury) obtained from the clinical records. The intra- and interobserver reliability of the MRI measurements, intra- and intergroup differences, and correlations between variables were also investigated. Receiver operating characteristic curves were calculated for evaluating the classification accuracy of the imaging variables for CSCI. RESULTS Data for 52 CSCI patients and 77 control patients were analyzed. The intra- and interobserver reliability regarding the MRI measurements ranged from good (0.72) to perfect (0.99). Differences between the CSCI group and the control group were significant (p < 0.001) for all parameters, except for the cord area. The most prominent differences between the groups existed for the spinal canal area, cord-canal-area ratio, and space available for the cord. The classification accuracy was best for the cord-canal-area ratio and the space available for the cord; areas under the curve were 0.99 (95% CI 0.97–1.0) and 0.98 (95% CI 0.95–0.99), respectively. There was no significant (p > 0.05) correlation between any of the imaging parameters and the motor index score at any time point. CONCLUSIONS The cord-canal-area ratio (> 0.8) or the space available for the cord (< 1.2 mm) measured on MR images can be used to reliably identify patients at risk for acute CSCI after a minor trauma to the cervical spine. However, there does not seem to be any association between spinal canal imaging characteristics and the severity of or recovery from CSCI after a minor trauma.

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Normal Cervical Spine Morphometry and Cervical Spinal Stenosis in Asymptomatic Professional Football Players

Cited by 214 publications

References 0 publications

Clinical evidence for cervical myelopathy due to Chiari malformation and spinal stenosis in a non-randomized group of patients with the diagnosis of fibromyalgia

Clinical evidence for cervical myelopathy due to Chiari malformation and spinal stenosis in a non-randomized group of patients with the diagnosis of fibromyalgia

Clinical relationship between cervical spinal canal stenosis and traumatic cervical spinal cord injury without major fracture or dislocation

The diagnostic value of magnetic resonance imaging measurements for assessing cervical spinal canal stenosis

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