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01-05-2013 | Original Article

Measurement of volume-occupying rate of cervical spinal canal and its role in cervical spondylotic myelopathy

Authors: Fulong Dong, Cailiang Shen, Shu Jiang, Renjie Zhang, Peiwen Song, Yongqiang Yu, Shiyu Wang, Xiaohu Li, Gang Zhao, Changhai Ding

Published in: European Spine Journal | Issue 5/2013

Abstract

Purpose

To compare volume-occupying rate of cervical spinal canal between patients with cervical spondylotic myelopathy (CSM) and normal subjects, and to investigate its significance in cervical spine disease.

Methods

Spiral computed tomography (CT) scan (C4–C6 cervical spine unit) was performed in 20 normal subjects and 36 cases of CSM at a neutral position, and data were transferred to the Advantage Workstation Version 4.2 for assessment. Bony canal area and fibrous canal area in each cross section, and sagittal diameters of cervical spinal canal and cervical spinal body were measured. Volume-occupying rate of cervical spinal canal was calculated using MATLAB. Cervical spinal canal ratio and effective cervical spinal canal ratio were calculated, and Japanese Orthopaedic Association score was used to assess cervical spinal cord function.

Results

Volume-occupying rate of cervical spinal canal at a neutral position was significantly higher in CSM patients as compared to normal subjects (P < 0.01). There was no correlation between cervical spinal canal ratio and JOA score in CSM patients, with a Pearson’s correlation coefficient of 0.171 (P > 0.05). However, sagittal diameter of secondary cervical spinal canal, effective cervical spinal canal ratio and volume-occupying rate of cervical spinal canal were significantly associated to JOA score, with Pearson’s coefficient correlations of 0.439 (P < 0.05), 0.491 (P < 0.05) and −0.613 (P < 0.01), respectively.

Conclusions

Volume-occupying rate of cervical spinal canal is an objective reflection of compression on cervical spine and spinal cord, and it is associated with cervical spinal cord function. These suggest that it may play a significant role in predicting the development of CSM.

Bernhardt M, Hynes RA, Blume HW, White AA 3rd (1993) Cervical spondylotic myelopathy. J Bone Joint Surg Am 75(1):119–128PubMed

Morishita Y, Naito M, Hymanson H, Miyazaki M, Wu G, Wang JC (2009) The relationship between the cervical spinal canal diameter and the pathological changes in the cervical spine. Eur Spine J 18(6):877–883PubMedCrossRef

Torg JS, Pavlov H, Genuario SE, Sennett B, Wisneski RJ, Robie BH, Jahre C (1986) Neurapraxia of the cervical spinal cord with transient quadriplegia. J Bone Joint Surg Am 68(9):1354–1370PubMed

Pavlov H, Torg JS, Robie B, Jahre C (1987) Cervical spinal stenosis: determination with vertebral body ratio method. Radiology 164(3):771–775PubMed

Blackley HR, Plank LD, Robertson PA (1999) Determining the sagittal dimensions of the canal of the cervical spine. The reliability of ratios of anatomical measurements. J Bone Joint Surg Br 81(1):110–112PubMedCrossRef

Lim JK, Wong HK (2004) Variation of the cervical spinal Torg ratio with gender and ethnicity. Spine J 4(4):396–401PubMedCrossRef

Keny SM, Suh SW, Song HR, Vaidya SV, Machavarapu MM (2006) Morphometric determinants of the sagittal dimensions of the cervical spinal canal in achondroplasia: an analysis of the reliability of the Torg ratio. J Spinal Disord Tech 19(7):523–527PubMedCrossRef

Suk KS, Kim KT, Lee JH, Lee SH, Kim JS, Kim JY (2009) Reevaluation of the Pavlov ratio in patients with cervical myelopathy. Clin Orthop Surg 1(1):6–10PubMedCrossRef

Okada Y, Ikata T, Katoh S, Yamada H (1994) Morphologic analysis of the cervical spinal cord, dural tube, and spinal canal by magnetic resonance imaging in normal adults and patients with cervical spondylotic myelopathy. Spine (Phila Pa 1976) 19(20):2331–2335CrossRef

10.

Golash A, Birchall D, Laitt RD, Jackson A (2001) Significance of CSF area measurements in cervical spondylitic myelopathy. Br J Neurosurg 15(1):17–21PubMedCrossRef

11.

Prasad SS, O’Malley M, Caplan M, Shackleford IM, Pydisetty RK (2003) MRI measurements of the cervical spine and their correlation to Pavlov’s ratio. Spine (Phila Pa 1976) 28(12):1263–1268

12.

Tench CR, Morgan PS, Constantinescu CS (2005) Measurement of cervical spinal cord cross-sectional area by MRI using edge detection and partial volume correction. J Magn Reson Imaging 21(3):197–203PubMedCrossRef

13.

Kadanka Z, Kerkovsky M, Bednarik J, Jarkovsky J (2007) Cross-sectional transverse area and hyperintensities on magnetic resonance imaging in relation to the clinical picture in cervical spondylotic myelopathy. Spine (Phila Pa 1976) 32(23):2573–2577CrossRef

14.

Naganawa T, Miyamoto K, Ogura H, Suzuki N, Shimizu K (2011) Comparison of magnetic resonance imaging and computed tomogram-myelography for evaluation of cross sections of cervical spinal morphology. Spine (Phila Pa 1976) 36(1):50–56

15.

Holmes A, Han ZH, Dang GT, Chen ZQ, Wang ZG, Fang J (1996) Changes in cervical canal spinal volume during in vitro flexion–extension. Spine (Phila Pa 1976) 21(11):1313–1319CrossRef

16.

Wada E, Suzuki S, Kanazawa A, Matsuoka T, Miyamoto S, Yonenobu K (2001) Subtotal corpectomy versus laminoplasty for multilevel cervical spondylotic myelopathy: a long-term follow-up study over 10 years. Spine (Phila Pa 1976) 26:1443–1447 discussion 48CrossRef

17.

Schriger DL, Larmon B, LeGassick T, Blinman T (1991) Spinal immobilization on a flat backboard: does it result in neutral position of the cervical spine? Ann Emerg Med 20(8):878–881PubMedCrossRef

18.

Yanase M, Matsuyama Y, Hirose K, Takagi H, Yamada M, Iwata H, Ishiguro N (2006) Measurement of the cervical spinal cord volume on MRI. J Spinal Disord Tech 19(2):125–129PubMedCrossRef

19.

Chen CJ, Hsu HL, Niu CC, Chen TY, Chen MC, Tseng YC, Wong YC, Wang LJ (2003) Cervical degenerative disease at flexion-extension MR imaging: prediction criteria. Radiology 227(1):136–142PubMedCrossRef

20.

Wheeldon J, Khouphongsy P, Kumaresan S, Yoganandan N, Pintar FA (2000) Finite element model of human cervical spinal column. Biomed Sci Instrum 36:337–342PubMed

21.

Panzer MB, Cronin DS (2009) C4–C5 segment finite element model development, validation, and load-sharing investigation. J Biomech 42(4):480–490PubMedCrossRef

22.

Raghavendra BN, Epstein FJ (1985) Sonography of the spine and spinal cord. Radiol Clin North Am 23(1):91–105PubMed

23.

Kaiser JA, Holland BA (1998) Imaging of the cervical spine. Spine (Phila Pa 1976) 23(24):2701–2712CrossRef

24.

Moor H (2008) MATLAB for Engineers, 2/E. Prentice Hall, Englewood Cliffs

25.

Stafira JS, Sonnad JR, Yuh WT, Huard DR, Acker RE, Nguyen DL, Maley JE, Ramji FG, Li WB, Loftus CM (2003) Qualitative assessment of cervical spinal stenosis: observer variability on CT and MR images. AJNR Am J Neuroradiol 24(4):766–769PubMed

26.

Nuckley DJ, Konodi MA, Raynak GC, Ching RP, Mirza SK (2002) Neural space integrity of the lower cervical spine: effect of normal range of motion. Spine (Phila Pa 1976) 27(6):587–595CrossRef

27.

Bapat Mihir R, Chaudhary Kshitij, Sharma Amit, Laheri Vinod (2008) Surgical approach to cervical spondylotic myelopathy on the basis of radiological patterns of compression: prospective analysis of 129 cases. Eur Spine J 17(12):1651–1663PubMedCrossRef

28.

Schultz KD Jr, McLaughlin MR, Haid RW Jr, Comey CH, Rodts GE Jr, Alexander J (2000) Single-stage anterior–posterior decompression and stabilization for complex cervical spine disorders. J Neurosurg 93(2 Suppl):214–221PubMed

29.

Hirabayashi Shigeru, Yamada Hironobu, Motosuneya Takao, Watanabe Yoshinobu, Miura Makoto, Sakai Hiroya, Matsushita Takashi (2010) Comparison of enlargement of the spinal canal after cervical laminoplasty: open-door type and double-door type. Eur Spine J 19(10):1690–1694PubMedCrossRef

Title: Measurement of volume-occupying rate of cervical spinal canal and its role in cervical spondylotic myelopathy
Authors: Fulong Dong
Cailiang Shen
Shu Jiang
Renjie Zhang
Peiwen Song
Yongqiang Yu
Shiyu Wang
Xiaohu Li
Gang Zhao
Changhai Ding
Publication date: 01-05-2013
Publisher: Springer-Verlag
Published in: European Spine Journal / Issue 5/2013
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-012-2622-3

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Springer Medicine

Measurement of volume-occupying rate of cervical spinal canal and its role in cervical spondylotic myelopathy

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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