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Can multi-positional magnetic resonance imaging be used to evaluate angular parameters in cervical spine? A comparison of multi-positional MRI to dynamic plain radiograph

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Abstract

Purpose

To test the reliability and validity of the multi-positional magnetic resonance imaging (MRI) in measuring cervical angular parameter using the standard dynamic cervical X-ray as a reference.

Methods

All patients who underwent both cervical dynamic plain radiograph and multi-positional MRI on the same day between 2010 and 2016 were included in this study. The C2–7 angle and the segmental angles of the C2–3 to C6–7 segments were measured in all three positions (neutral, flexion, and extension) using multi-positional MRI and dynamic radiograph. The Pearson’s correlation coefficients and linear regression analysis were used for statistical analysis.

Results

46 patients were enrolled in this study. All angular parameters showed significant positive correlation between multi-positional MRI and dynamic X-ray (p < 0.05). The angle of C2–7 showed significantly positive correlation between multi-positional MRI and X-ray (r = 0.552–0.756). All segmental angles from C2–3 to C6–7 showed moderate correlation (r = 0.401–0.636). The linear regression analysis showed that C2–7 angles and all angular parameters had significant correlation between multi-positional MRI and dynamic X-ray (p < 0.05, R 2 = 0.107–0.571).

Conclusions

The C2–7 angle and segmental cervical angles measured by multi-positional MRI were valid, and reliability substituted the dynamic X-ray measurement within the acceptable range of error. Multi-positional MRI can be used as a reliable tool for angular parameter measurement and detection of angular instability in the cervical spine.

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Acknowledgements

This work was funded by departmental funds. The authors would like to thank AiM Radiology Medical Group, especially to Yusuf A. Khan, Sameer U. Khan and Aziza Qadir MD for their help on obtaining and uploading kMRI images into the database.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Keck School of Medicine, University of Southern California, 1450 Biggy Street, NRT-4513, Los Angeles, CA, 90033, USA

    Permsak Paholpak, Koji Tamai, Kyle Shoell, Kittipong Sessumpun, Zorica Buser & Jeffrey C. Wang

  2. Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

    Permsak Paholpak

  3. Department of Orthopedics, Osaka City University Graduate School of Medicine, Osaka, Japan

    Koji Tamai

  4. Department of Orthopaedics, Khon Kaen General Hospital, Khon Kaen, Thailand

    Kittipong Sessumpun

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  1. Permsak Paholpak
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  2. Koji Tamai
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  4. Kittipong Sessumpun
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  5. Zorica Buser
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  6. Jeffrey C. Wang
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Corresponding author

Correspondence to Zorica Buser.

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Conflict of interest

All authors declare that they have no conflict of interest. Disclosures: ZB-Xenco Medical (consultancy), AO Spine (consultancy, past); JCW–Royalties: Aesculap, Biomet, Amedica, Seaspine, Synthes; Stock Ownership: Fziomed; Private Investments: Promethean Spine, Paradigm spine, Benevenue, NexGen, Vertiflex, ElectroCore, Surgitech, Expanding Orthopaedics, Osprey, Bone Biologics, Curative Biosciences, PearlDiver; Board of Directors: North American Spine Society (Second Vice President), North American Spine Foundation (non-financial), Cervical Spine Research Society (Travel expenses), AO Spine/AO Foundation (honorariums for board position); Fellowship Support: AO Foundation (spine fellowship funding paid to institution).

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Paholpak, P., Tamai, K., Shoell, K. et al. Can multi-positional magnetic resonance imaging be used to evaluate angular parameters in cervical spine? A comparison of multi-positional MRI to dynamic plain radiograph. Eur Spine J 27, 1021–1027 (2018). https://doi.org/10.1007/s00586-017-5306-1

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  • DOI: https://doi.org/10.1007/s00586-017-5306-1

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