Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan 1;44(1):E26-E32.
doi: 10.1097/BRS.0000000000002765.

A Technique for Dynamic Cervical Magnetic Resonance Imaging Applied to Cervical Spondylotic Myelopathy: A Reliability Study

Raphael R Pratali  1 , Justin S Smith  2 , Bruno C Ancheschi  3 , Daniel A Maranho  3 , Aniello Savarese  3 , Marcello H Nogueira-Barbosa  4 , Carlos Fernando P S Herrero  3
Affiliations

A Technique for Dynamic Cervical Magnetic Resonance Imaging Applied to Cervical Spondylotic Myelopathy: A Reliability Study

Raphael R Pratali et al. Spine (Phila Pa 1976). .

Abstract

Study design: Cross-sectional study.

Objective: To evaluate morphometric variations of the cervical spine in patients with cervical spondylotic myelopathy (CSM) using a standard technique of dynamic magnetic resonance imaging (MRI), to assess the inter- and intraobserver reliability of measurements of morphometric parameters based on this imaging, and to compare the resulting measurements with those previously published.

Summary of background data: Because dynamic factors may contribute to the etiology and severity of CSM, dynamic (flexion-extension) MRI may be useful to better evaluate for spinal stenosis and cord compromise.

Methods: Dynamic cervical MRI was obtained using a standard protocol with the neck in neutral, flexion, and extension positions. The morphometric parameters considered were anterior length of the spinal cord (ALSC), posterior length of the spinal cord (PLSC), spinal canal diameter, and spinal cord width. Two observers analyzed the parameters independently, and the inter- and intraobserver reliabilities were assessed by the intraclass correlation coefficient (ICC).

Results: A total of 18 patients were included in the study and all completed the dynamic MRI acquisition protocol. The inter- and intraobserver reliabilities demonstrated "almost perfect agreement" (ICC >0.9, P < 0.001) for ALSC and PLSC in all positions. The spinal canal diameter had inter- and intraobserver reliability classified as "almost perfect agreement" (ICC: 0.83-0.98, P < 0.001 and ICC: 0.90-0.99, P < 0.001, respectively) in all positions. The spinal cord width had inter- and intraobserver reliability classified as "substantial agreement" (ICC: 0.73-0.94, P < 0.001 and ICC: 0.79-0.96, P < 0.001, respectively) in all positions. ALSC and PLSC in neutral, flexion, and extension positions from the present study were significantly greater compared to the measurements previously published (P < 0.001).

Conclusion: The dynamic MRI protocol presented was safe and may allow a more complete evaluation of variations in the cervical spine in patients with CSM than traditional MRI protocols. The morphometric parameters based on this protocol demonstrated excellent inter- and intraobserver reliabilities.

Level of evidence: 4.

PubMed Disclaimer

References

    1. Hukuda S, Mochizuki T, Ogata M, et al. Operations for cervical spondylotic myelopathy a comparison of the results of anterior and posterior procedures. J Bone Joint Surg Br 1985; 67:609–615.
    1. Singh A, Tetreault L, Casey A, et al. A summary of assessment tools for patients suffering from cervical spondylotic myelopathy: a systematic review on validity, reliability and responsiveness. Eur Spine J 2015; 24 (suppl 2):209–228.
    1. Chen IH, Vasavada A, Panjabi MM. Kinematics of the spondylitic spine canal: changes with sagittal plane loads. J Spinal Disord 1994; 7:93–101.
    1. Nouri A, Tetreault L, Singh A, et al. Degenerative cervical myelopathy: epidemiology, genetics and pathogenesis. Spine (Phila Pa 1976) 2015; 40:E675–E693.
    1. Turnbull IM, Brieg A, Hassler O. Blood supply of cervical spinal cord in man. A microangiographic cadaver study. J Neurosurg 1966; 24:951–965.