The optimal radiologic method for assessing spinal canal compromise and cord compression in patients with cervical spinal cord injury: Part II: Results of a multicenter study

M. G. Fehlings, S. C. Rao, C. H. Tator, G. Skaf, P. Arnold, E. Benzel, C. Dickman, B. Cuddy, Barth A Green, P. Hitchon, B. Northrup, V. Sonntag, F. Wagner, J. Wilberger

Research output: Contribution to journalArticle

96 Citations (Scopus)

Abstract

Study Design. A multicenter, retrospective study using computed tomographic and magnetic resonance imaging data to establish quantitative, reliable criteria of canal compromise and cord compression in patients with cervical spinal cord injury. Objectives. To develop and validate a radiologic assessment tool of spinal canal compromise and cord compression in cervical spinal cord injury use in clinical trials. Summary of Background Data. There are few quantitative, reliable criteria for radiologic measurement of cervical spinal canal compromise or cord compression after acute spinal cord injury. Methods. The study included 71 patients (55 men, 16 women; mean age, 39.7 ± 18.7 years) with acute cervical spinal cord injury. Causes of spinal cord injury included motor vehicle accidents (n = 36), falls (n = 20), water- related injuries (n = 8), sports (n = 5), assault (n = 1), and farm accidents (n = 1). Canal compromise was measured on computed tomographic scan and T1- and T2-weighted magnetic resonance imaging, and cord compression at the level of maximum injury-was measured on T1- and T2-weighted magnetic resonance imaging. All films were assessed by two independent observers. Results. There was a strong correlation of canal compromise and/or cord compression measurements between axial and midsagittal computed tomography, and between axial and midsagittal T2-weighted magnetic resonance imaging. Spinal canal compromise assessed by computed tomography showed a significant although moderate correlation with spinal cord compression assessed by T1- and T2- weighted magnetic resonance imaging. Virtually all patients with canal compromise of 25% or more on computed tomographic scan had evidence of some degree of cord compression on magnetic resonance imaging, but a large number of patients with less than 25% canal compromise on computed tomographic scan also had evidence on magnetic resonance imaging of cord compression. Conclusions. In patients with cervical spinal cord injury, the midsagittal T1- and T2-weighted magnetic resonance imaging provides an objective, quantifiable, and reliable assessment of spinal cord compression that cannot be adequately assessed by computed tomography alone.

Original languageEnglish
Pages (from-to)605-613
Number of pages9
JournalSpine
Volume24
Issue number6
DOIs
StatePublished - Mar 15 1999
Externally publishedYes

Fingerprint

Spinal Canal
Spinal Cord Injuries
Multicenter Studies
Spinal Cord
Magnetic Resonance Imaging
Spinal Cord Compression
Tomography
Accidents
Cervical Cord
Wounds and Injuries
Motor Vehicles
Sports
Retrospective Studies
Clinical Trials
Water

Keywords

  • Cervical spinal cord injury
  • Clinical trial
  • Computed tomography
  • Magnetic resonance imaging
  • Outcome measure

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

The optimal radiologic method for assessing spinal canal compromise and cord compression in patients with cervical spinal cord injury : Part II: Results of a multicenter study. / Fehlings, M. G.; Rao, S. C.; Tator, C. H.; Skaf, G.; Arnold, P.; Benzel, E.; Dickman, C.; Cuddy, B.; Green, Barth A; Hitchon, P.; Northrup, B.; Sonntag, V.; Wagner, F.; Wilberger, J.

In: Spine, Vol. 24, No. 6, 15.03.1999, p. 605-613.

Research output: Contribution to journalArticle

Fehlings, MG, Rao, SC, Tator, CH, Skaf, G, Arnold, P, Benzel, E, Dickman, C, Cuddy, B, Green, BA, Hitchon, P, Northrup, B, Sonntag, V, Wagner, F & Wilberger, J 1999, 'The optimal radiologic method for assessing spinal canal compromise and cord compression in patients with cervical spinal cord injury: Part II: Results of a multicenter study', Spine, vol. 24, no. 6, pp. 605-613. https://doi.org/10.1097/00007632-199903150-00023
Fehlings, M. G. ; Rao, S. C. ; Tator, C. H. ; Skaf, G. ; Arnold, P. ; Benzel, E. ; Dickman, C. ; Cuddy, B. ; Green, Barth A ; Hitchon, P. ; Northrup, B. ; Sonntag, V. ; Wagner, F. ; Wilberger, J. / The optimal radiologic method for assessing spinal canal compromise and cord compression in patients with cervical spinal cord injury : Part II: Results of a multicenter study. In: Spine. 1999 ; Vol. 24, No. 6. pp. 605-613.
@article{3b41e21d17304907a2d8dcc64773bf8f,
title = "The optimal radiologic method for assessing spinal canal compromise and cord compression in patients with cervical spinal cord injury: Part II: Results of a multicenter study",
abstract = "Study Design. A multicenter, retrospective study using computed tomographic and magnetic resonance imaging data to establish quantitative, reliable criteria of canal compromise and cord compression in patients with cervical spinal cord injury. Objectives. To develop and validate a radiologic assessment tool of spinal canal compromise and cord compression in cervical spinal cord injury use in clinical trials. Summary of Background Data. There are few quantitative, reliable criteria for radiologic measurement of cervical spinal canal compromise or cord compression after acute spinal cord injury. Methods. The study included 71 patients (55 men, 16 women; mean age, 39.7 ± 18.7 years) with acute cervical spinal cord injury. Causes of spinal cord injury included motor vehicle accidents (n = 36), falls (n = 20), water- related injuries (n = 8), sports (n = 5), assault (n = 1), and farm accidents (n = 1). Canal compromise was measured on computed tomographic scan and T1- and T2-weighted magnetic resonance imaging, and cord compression at the level of maximum injury-was measured on T1- and T2-weighted magnetic resonance imaging. All films were assessed by two independent observers. Results. There was a strong correlation of canal compromise and/or cord compression measurements between axial and midsagittal computed tomography, and between axial and midsagittal T2-weighted magnetic resonance imaging. Spinal canal compromise assessed by computed tomography showed a significant although moderate correlation with spinal cord compression assessed by T1- and T2- weighted magnetic resonance imaging. Virtually all patients with canal compromise of 25{\%} or more on computed tomographic scan had evidence of some degree of cord compression on magnetic resonance imaging, but a large number of patients with less than 25{\%} canal compromise on computed tomographic scan also had evidence on magnetic resonance imaging of cord compression. Conclusions. In patients with cervical spinal cord injury, the midsagittal T1- and T2-weighted magnetic resonance imaging provides an objective, quantifiable, and reliable assessment of spinal cord compression that cannot be adequately assessed by computed tomography alone.",
keywords = "Cervical spinal cord injury, Clinical trial, Computed tomography, Magnetic resonance imaging, Outcome measure",
author = "Fehlings, {M. G.} and Rao, {S. C.} and Tator, {C. H.} and G. Skaf and P. Arnold and E. Benzel and C. Dickman and B. Cuddy and Green, {Barth A} and P. Hitchon and B. Northrup and V. Sonntag and F. Wagner and J. Wilberger",
year = "1999",
month = "3",
day = "15",
doi = "10.1097/00007632-199903150-00023",
language = "English",
volume = "24",
pages = "605--613",
journal = "Spine",
issn = "0362-2436",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - The optimal radiologic method for assessing spinal canal compromise and cord compression in patients with cervical spinal cord injury

T2 - Part II: Results of a multicenter study

AU - Fehlings, M. G.

AU - Rao, S. C.

AU - Tator, C. H.

AU - Skaf, G.

AU - Arnold, P.

AU - Benzel, E.

AU - Dickman, C.

AU - Cuddy, B.

AU - Green, Barth A

AU - Hitchon, P.

AU - Northrup, B.

AU - Sonntag, V.

AU - Wagner, F.

AU - Wilberger, J.

PY - 1999/3/15

Y1 - 1999/3/15

N2 - Study Design. A multicenter, retrospective study using computed tomographic and magnetic resonance imaging data to establish quantitative, reliable criteria of canal compromise and cord compression in patients with cervical spinal cord injury. Objectives. To develop and validate a radiologic assessment tool of spinal canal compromise and cord compression in cervical spinal cord injury use in clinical trials. Summary of Background Data. There are few quantitative, reliable criteria for radiologic measurement of cervical spinal canal compromise or cord compression after acute spinal cord injury. Methods. The study included 71 patients (55 men, 16 women; mean age, 39.7 ± 18.7 years) with acute cervical spinal cord injury. Causes of spinal cord injury included motor vehicle accidents (n = 36), falls (n = 20), water- related injuries (n = 8), sports (n = 5), assault (n = 1), and farm accidents (n = 1). Canal compromise was measured on computed tomographic scan and T1- and T2-weighted magnetic resonance imaging, and cord compression at the level of maximum injury-was measured on T1- and T2-weighted magnetic resonance imaging. All films were assessed by two independent observers. Results. There was a strong correlation of canal compromise and/or cord compression measurements between axial and midsagittal computed tomography, and between axial and midsagittal T2-weighted magnetic resonance imaging. Spinal canal compromise assessed by computed tomography showed a significant although moderate correlation with spinal cord compression assessed by T1- and T2- weighted magnetic resonance imaging. Virtually all patients with canal compromise of 25% or more on computed tomographic scan had evidence of some degree of cord compression on magnetic resonance imaging, but a large number of patients with less than 25% canal compromise on computed tomographic scan also had evidence on magnetic resonance imaging of cord compression. Conclusions. In patients with cervical spinal cord injury, the midsagittal T1- and T2-weighted magnetic resonance imaging provides an objective, quantifiable, and reliable assessment of spinal cord compression that cannot be adequately assessed by computed tomography alone.

AB - Study Design. A multicenter, retrospective study using computed tomographic and magnetic resonance imaging data to establish quantitative, reliable criteria of canal compromise and cord compression in patients with cervical spinal cord injury. Objectives. To develop and validate a radiologic assessment tool of spinal canal compromise and cord compression in cervical spinal cord injury use in clinical trials. Summary of Background Data. There are few quantitative, reliable criteria for radiologic measurement of cervical spinal canal compromise or cord compression after acute spinal cord injury. Methods. The study included 71 patients (55 men, 16 women; mean age, 39.7 ± 18.7 years) with acute cervical spinal cord injury. Causes of spinal cord injury included motor vehicle accidents (n = 36), falls (n = 20), water- related injuries (n = 8), sports (n = 5), assault (n = 1), and farm accidents (n = 1). Canal compromise was measured on computed tomographic scan and T1- and T2-weighted magnetic resonance imaging, and cord compression at the level of maximum injury-was measured on T1- and T2-weighted magnetic resonance imaging. All films were assessed by two independent observers. Results. There was a strong correlation of canal compromise and/or cord compression measurements between axial and midsagittal computed tomography, and between axial and midsagittal T2-weighted magnetic resonance imaging. Spinal canal compromise assessed by computed tomography showed a significant although moderate correlation with spinal cord compression assessed by T1- and T2- weighted magnetic resonance imaging. Virtually all patients with canal compromise of 25% or more on computed tomographic scan had evidence of some degree of cord compression on magnetic resonance imaging, but a large number of patients with less than 25% canal compromise on computed tomographic scan also had evidence on magnetic resonance imaging of cord compression. Conclusions. In patients with cervical spinal cord injury, the midsagittal T1- and T2-weighted magnetic resonance imaging provides an objective, quantifiable, and reliable assessment of spinal cord compression that cannot be adequately assessed by computed tomography alone.

KW - Cervical spinal cord injury

KW - Clinical trial

KW - Computed tomography

KW - Magnetic resonance imaging

KW - Outcome measure

UR - http://www.scopus.com/inward/record.url?scp=0033559941&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0033559941&partnerID=8YFLogxK

U2 - 10.1097/00007632-199903150-00023

DO - 10.1097/00007632-199903150-00023

M3 - Article

C2 - 10101829

AN - SCOPUS:0033559941

VL - 24

SP - 605

EP - 613

JO - Spine

JF - Spine

SN - 0362-2436

IS - 6

ER -