Article Review 7

Authors' names
Douglas S. Weinberg, Arunit J. Chugh, Jeremy J. Gebhart, Jason D. Eubanks.

Article title
Magnetic Resonance Imaging of the Cervical Spine Under-Represents Sagittal Plane Deformity in Degenerative Myelopathy Patients

Journal name
International Journal of Spine Surgery

Bibliography

Weinberg, D. S., Chugh, A. J., Gebhart, J. J., & Eubanks, J. D. (2016). Magnetic Resonance Imaging of the Cervical Spine Under-Represents Sagittal Plane Deformity in Degenerative Myelopathy Patients. International journal of spine surgery, 10, 32. doi:10.14444/3032

Purpose of the article

The purpose of this article was to show differentiate of magnetic resonance imaging images and plain radiographs in identifying the curvature index of cervical myelopathy patients.

Brief Description of Procedure and Findings/Results

This experiment was conducted using retrospective study which involved series of 151 patients whose history, physical exam, and imaging were consistent with the diagnosis of cervical myelopathy. Criteria were had high-quality plain radiographs of the lateral cervical spine in a standing, upright position, and T1 and T2-weighted magnetic resonance imaging (MRI) of the cervical spine available for review. The curvature angle was measured on plain radiographs of the lateral cervical spine and sagittal image of MRI using the four-line Cobb technique, from the base of C2 to the base of C7. The curvature index was measured on plain film of the lateral cervical spine and sagittal image of MRI using the Ishihara technique. All data then was analyzed for skewness and kurtosis. Comparisons between the differences of continuous variables were performed with t-tests. Correlations between continuous variables were performed with the Pearson’s correlation coefficient or Spearman’s rank correlation coefficient, where parametrically appropriate. The result obtained was the average difference between plain radiograph and MRI measurements for curvature angle was 3.5± 7.2 degrees (p< 0.001), and the average difference between plain radiograph and MRI measurements for curvature index was 1.5± 5.9 degrees (p= 0.015).

Conclusions and Comments

Radiographic review of 101 patients with cervical myelopathy showed that important differences exist in the measurement of sagittal balance on plain radiograph and MRI when using a variety of techniques. Standing, upright radiographs of the lateral cervical spine has been the gold standard for evaluating cervical lordosis or kyphosis.

The opinion of the article

I found this article is very useful in determining what the advantage and disadvantage of radiographic modalities. Ligaments, tendon and other soft tissue might represent the best in magnetic resonance but this article proved that lordosis and kyphosis of cervical myelopathy are best demonstrated through lateral plain x-ray.