Radiological Assessment of the Effects of Anterior Cervical Discectomy and Fusion on Distraction of the Posterior Ligamentum Flavum in Patients with Degenerative Cervical Spines

Choi, Byung Wan; Choi, Min Sung; Kwon, Min Sung; Chang, Han

doi:10.4055/cios20262

Cited by 8 publications

(13 citation statements)

References 23 publications

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“…First, patients should have had specific symptoms when visiting the outpatient clinic. These symptoms included hand clumsiness, gait disturbance, hand or arm weakness, and other minor symptoms that have been described in the previous studies [ 1 , 8 , 9 , 11 ]. In addition, they had positive signs of CSM on physical examination (including increased upper extremities reflexes, positive pathological reflexes, decreased performance on the grip and release test, and difficulties with tandem gait).…”

Section: Methodsmentioning

confidence: 93%

“…Cervical spondylotic myelopathy (CSM) is a clinical manifestation of cervical spinal cord impairment related to the narrowing of the cervical canal, and it is due to compressive forces acting on the cervical cord [1][2][3][4][5][6][7]. Because the spinal cord is repeatedly injured during cervical motion, especially during extension, cervical cord compression is known to be aggravated in neck extension postures [1,[8][9][10][11]. Therefore, during the diagnosis and treatment of CSM, this unique feature of the cervical spine (i.e., segmental instability) should be considered.…”

Section: Introductionmentioning

confidence: 99%

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High reliability and accuracy of dynamic magnetic resonance imaging in the diagnosis of cervical Spondylotic myelopathy: a multicenter study

Park

Min

Shin

et al. 2022

BMC Musculoskelet Disord

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Background Cervical spondylotic myelopathy (CSM) is a critical condition that results in significant neurologic deterioration. An accurate diagnosis is essential for determining its outcome and prognosis. The pathology is strongly associated with dynamic factors; therefore, dynamic magnetic resonance (MR) image could be crucial to accurately detect CSM. However, very few studies have evaluated the reliability and accuracy of dynamic MR in CSM. In this study, we aimed to compare intra- and interobserver reliabilities and accuracy of dynamic MR in detecting CSM using sagittal MR scans of the neck in the flexed, neutral, and extended position. Methods Out of 131 patients who underwent surgical treatments for CSM, 107 were enrolled in this study. The patient underwent three-types of sagittal MR scans that were obtained separately in different neck positions (neutral, flexion, and extension postures). The MR scans of the cervical spine were evaluated independently by three spine professionals, on the basis of tabled questionnaires. For accuracy, we performed a receiver operator characteristic analysis, and the overall discriminating ability of each method was measured by calculating the area under the ROC curve. The Cohen’s kappa coefficient and the Fleiss-generalized kappa coefficient was used to the inter- and intra-observer reliabilities. Results The intraobserver reliability (using the Cohen’s kappa coefficient) and interobserver reliability (using the Fless kappa coefficient) were respectively 0.64 and 0.52 for the neutral sagittal MR. The accuracy of neutral sagittal MR in detecting CSM was 0.735 (95% CI, 0.720 to 0.741) while that of extension sagittal MRI was 0.932 (96% CI, 0.921 to 0.948). Conclusions Dynamic MR significantly showed better diagnostic reliability and accuracy in detecting CSM compared to conventional MR. In particular, extension MR scans could provide a more accurate diagnosis than other images.

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Section: Methodsmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

High reliability and accuracy of dynamic magnetic resonance imaging in the diagnosis of cervical Spondylotic myelopathy: a multicenter study

Park

Min

Shin

et al. 2022

BMC Musculoskelet Disord

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“…With the development of modern radiographic technologies, advanced imaging modalities have been introduced. Nevertheless, plain radiograph remains the first and most widely used imaging modality for localizing suspected spinal symptoms, including pain, numbness, and weakness [6]. Radiography aids intuitive recognition of the patient's condition since it provides overall information about each spinal segment and the entire vertebral column in a few images [7].…”

Section: Plain Radiographymentioning

confidence: 99%

Diagnostic Technology for Spine Pathology

et al. 2022

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Diagnostic techniques for spinal pathologies have been developed in accordance with advances in technology. Accurate diagnosis of spinal pathology is essential for appropriate management of spinal diseases. Since the development of X-rays in 1895 and computed tomography (CT) in 1967, several diagnostic imaging modalities have been utilized for detecting spinal pathologies, including radiography, CT, magnetic resonance imaging, and radionuclide imaging. In addition to diagnostic imaging technologies, electrodiagnostic tests, including electromyography and nerve conduction studies, play a significant role as diagnostic tools, as spinal diseases are mostly profoundly associated with pathologies of the neural structures, such as the spinal cord and nerve root, and extent of injury at the structure cannot be adequately detected by conventional imaging techniques. In patient-specific treatment strategies, usage of diagnostic modalities is of great importance; thus, we should be aware of the basic details and approaches of the different diagnostic modalities. In this review, the authors discuss the details of the technologies that aid in the diagnosis of spinal pathologies.

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“…Cervical spondylotic myelopathy (CSM) is a neurological condition caused by progressive degenerative changes in the intervertebral discs, facets, ligaments, and vertebrae of the cervical spine [ 1 – 3 ]. These degenerative changes directly compress the spinal cord, and CSM is the leading cause of spinal cord injury in adults, accounting for over half of non-traumatic spinal cord injuries [ 2 , 4 , 5 ]. CSM results in motor and sensory deficits, and neuropathic pain, which further cause long-term disability [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Deep learning algorithm to evaluate cervical spondylotic myelopathy using lateral cervical spine radiograph

2022

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Background Deep learning (DL) is an advanced machine learning approach used in different areas such as image analysis, bioinformatics, and natural language processing. A convolutional neural network (CNN) is a representative DL model that is highly advantageous for imaging recognition and classification This study aimed to develop a CNN using lateral cervical spine radiograph to detect cervical spondylotic myelopathy (CSM). Methods We retrospectively recruited 207 patients who visited the spine center of a university hospital. Of them, 96 had CSM (CSM patients) while 111 did not have CSM (non-CSM patients). CNN algorithm was used to detect cervical spondylotic myelopathy. Of the included patients, 70% (145 images) were assigned randomly to the training set, while the remaining 30% (62 images) to the test set to measure the model performance. Results The accuracy of detecting CSM was 87.1%, and the area under the curve was 0.864 (95% CI, 0.780-0.949). Conclusion The CNN model using the lateral cervical spine radiographs of each patient could be helpful in the diagnosis of CSM.

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Radiological Assessment of the Effects of Anterior Cervical Discectomy and Fusion on Distraction of the Posterior Ligamentum Flavum in Patients with Degenerative Cervical Spines

Cited by 8 publications

References 23 publications

High reliability and accuracy of dynamic magnetic resonance imaging in the diagnosis of cervical Spondylotic myelopathy: a multicenter study

High reliability and accuracy of dynamic magnetic resonance imaging in the diagnosis of cervical Spondylotic myelopathy: a multicenter study

Diagnostic Technology for Spine Pathology

Deep learning algorithm to evaluate cervical spondylotic myelopathy using lateral cervical spine radiograph

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