Cervical degenerative disease at flexion-extension MR imaging: Prediction criteria

Chi J. Chen, Hui-Ling Hsu, Chi Chien Niu, Tzu Yung Chen, Min C. Chen, Ying C. Tseng, Yon Cheong Wong, Li J. Wang

Research output: Contribution to journalArticle

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Abstract

PURPOSE: To determine if there are any neutral-position imaging criteria that can help predict functional cord impingement at flexion-extension cervical magnetic resonance (MR) imaging. MATERIALS AND METHODS: Sixty-two patients with cervical degenerative disease were evaluated with regard to the dynamic changes of canal stenosis at flexion-extension MR imaging. Functional cord impingement was considered if the cord was impinged or more impinged after neck flexion or extension. Selection criteria for neutral-position MR imaging, such as cervical curvature, canal space, degenerative stage, intramedullary high signal intensity on T2-weighted images, and resting instability, were evaluated for their ability to predict functional cord impingement at flexion-extension MR imaging (Fisher exact test, logistic regression analysis). RESULTS: MR images in 19 (31%) of 62 patients showed functional cord impingement at extension MR imaging compared with images in two (3%) patients at flexion MR imaging. Statistically significant differences were found for the criteria cervical degeneration stage (P <.001) and spinal canal space (P = .037) for predicting functional cord impingement at extension MR imaging. In contrast, no significant differences were found among selection criteria for flexion MR imaging. Probabilities of functional cord impingement at extension MR imaging were calculated with different combinations of degenerative stages and canal spaces. Probability could increase to 79% if the patient had both stabilization degeneration (disk protrusion or osteophytic formation with hypertrophy of the ligamentum flavum) and C7 canal space of 10 mm or less. CONCLUSION: None of the selection criteria evaluated in this study has the ability to predict functional cord impingement at flexion MR imaging; however, prediction of impingement at extension MR imaging can increase from 31% to 79% if proper criteria are selected.

Original languageEnglish
Pages (from-to)136-142
Number of pages7
JournalRadiology
Volume227
Issue number1
DOIs
Publication statusPublished - Apr 1 2003
Externally publishedYes

Fingerprint

Magnetic Resonance Imaging
Patient Selection
Ligamentum Flavum
Intervertebral Disc Degeneration
Spinal Canal
Hypertrophy
Pathologic Constriction
Neck
Magnetic Resonance Spectroscopy
Logistic Models
Regression Analysis

Keywords

  • Spine, MR

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology

Cite this

Cervical degenerative disease at flexion-extension MR imaging : Prediction criteria. / Chen, Chi J.; Hsu, Hui-Ling; Niu, Chi Chien; Chen, Tzu Yung; Chen, Min C.; Tseng, Ying C.; Wong, Yon Cheong; Wang, Li J.

In: Radiology, Vol. 227, No. 1, 01.04.2003, p. 136-142.

Research output: Contribution to journalArticle

Chen, CJ, Hsu, H-L, Niu, CC, Chen, TY, Chen, MC, Tseng, YC, Wong, YC & Wang, LJ 2003, 'Cervical degenerative disease at flexion-extension MR imaging: Prediction criteria', Radiology, vol. 227, no. 1, pp. 136-142. https://doi.org/10.1148/radiol.2271020116
Chen, Chi J. ; Hsu, Hui-Ling ; Niu, Chi Chien ; Chen, Tzu Yung ; Chen, Min C. ; Tseng, Ying C. ; Wong, Yon Cheong ; Wang, Li J. / Cervical degenerative disease at flexion-extension MR imaging : Prediction criteria. In: Radiology. 2003 ; Vol. 227, No. 1. pp. 136-142.
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abstract = "PURPOSE: To determine if there are any neutral-position imaging criteria that can help predict functional cord impingement at flexion-extension cervical magnetic resonance (MR) imaging. MATERIALS AND METHODS: Sixty-two patients with cervical degenerative disease were evaluated with regard to the dynamic changes of canal stenosis at flexion-extension MR imaging. Functional cord impingement was considered if the cord was impinged or more impinged after neck flexion or extension. Selection criteria for neutral-position MR imaging, such as cervical curvature, canal space, degenerative stage, intramedullary high signal intensity on T2-weighted images, and resting instability, were evaluated for their ability to predict functional cord impingement at flexion-extension MR imaging (Fisher exact test, logistic regression analysis). RESULTS: MR images in 19 (31{\%}) of 62 patients showed functional cord impingement at extension MR imaging compared with images in two (3{\%}) patients at flexion MR imaging. Statistically significant differences were found for the criteria cervical degeneration stage (P <.001) and spinal canal space (P = .037) for predicting functional cord impingement at extension MR imaging. In contrast, no significant differences were found among selection criteria for flexion MR imaging. Probabilities of functional cord impingement at extension MR imaging were calculated with different combinations of degenerative stages and canal spaces. Probability could increase to 79{\%} if the patient had both stabilization degeneration (disk protrusion or osteophytic formation with hypertrophy of the ligamentum flavum) and C7 canal space of 10 mm or less. CONCLUSION: None of the selection criteria evaluated in this study has the ability to predict functional cord impingement at flexion MR imaging; however, prediction of impingement at extension MR imaging can increase from 31{\%} to 79{\%} if proper criteria are selected.",
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AU - Chen, Min C.

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AU - Wong, Yon Cheong

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N2 - PURPOSE: To determine if there are any neutral-position imaging criteria that can help predict functional cord impingement at flexion-extension cervical magnetic resonance (MR) imaging. MATERIALS AND METHODS: Sixty-two patients with cervical degenerative disease were evaluated with regard to the dynamic changes of canal stenosis at flexion-extension MR imaging. Functional cord impingement was considered if the cord was impinged or more impinged after neck flexion or extension. Selection criteria for neutral-position MR imaging, such as cervical curvature, canal space, degenerative stage, intramedullary high signal intensity on T2-weighted images, and resting instability, were evaluated for their ability to predict functional cord impingement at flexion-extension MR imaging (Fisher exact test, logistic regression analysis). RESULTS: MR images in 19 (31%) of 62 patients showed functional cord impingement at extension MR imaging compared with images in two (3%) patients at flexion MR imaging. Statistically significant differences were found for the criteria cervical degeneration stage (P <.001) and spinal canal space (P = .037) for predicting functional cord impingement at extension MR imaging. In contrast, no significant differences were found among selection criteria for flexion MR imaging. Probabilities of functional cord impingement at extension MR imaging were calculated with different combinations of degenerative stages and canal spaces. Probability could increase to 79% if the patient had both stabilization degeneration (disk protrusion or osteophytic formation with hypertrophy of the ligamentum flavum) and C7 canal space of 10 mm or less. CONCLUSION: None of the selection criteria evaluated in this study has the ability to predict functional cord impingement at flexion MR imaging; however, prediction of impingement at extension MR imaging can increase from 31% to 79% if proper criteria are selected.

AB - PURPOSE: To determine if there are any neutral-position imaging criteria that can help predict functional cord impingement at flexion-extension cervical magnetic resonance (MR) imaging. MATERIALS AND METHODS: Sixty-two patients with cervical degenerative disease were evaluated with regard to the dynamic changes of canal stenosis at flexion-extension MR imaging. Functional cord impingement was considered if the cord was impinged or more impinged after neck flexion or extension. Selection criteria for neutral-position MR imaging, such as cervical curvature, canal space, degenerative stage, intramedullary high signal intensity on T2-weighted images, and resting instability, were evaluated for their ability to predict functional cord impingement at flexion-extension MR imaging (Fisher exact test, logistic regression analysis). RESULTS: MR images in 19 (31%) of 62 patients showed functional cord impingement at extension MR imaging compared with images in two (3%) patients at flexion MR imaging. Statistically significant differences were found for the criteria cervical degeneration stage (P <.001) and spinal canal space (P = .037) for predicting functional cord impingement at extension MR imaging. In contrast, no significant differences were found among selection criteria for flexion MR imaging. Probabilities of functional cord impingement at extension MR imaging were calculated with different combinations of degenerative stages and canal spaces. Probability could increase to 79% if the patient had both stabilization degeneration (disk protrusion or osteophytic formation with hypertrophy of the ligamentum flavum) and C7 canal space of 10 mm or less. CONCLUSION: None of the selection criteria evaluated in this study has the ability to predict functional cord impingement at flexion MR imaging; however, prediction of impingement at extension MR imaging can increase from 31% to 79% if proper criteria are selected.

KW - Spine, MR

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