The Radiologist will usually comment on the alignment of the vertebrae and the presence or absence of any ‘wear and tear’ changes, usually related to normal aging and known as degenerative changes or osteoarthritis. Sometimes, a Radiologist may also be requested to interpret the images.Ĭ-Spine X-Rays taken in the non-urgent setting are reported by a Radiologist, and the report is usually sent to the doctor who ordered the test. In cases of trauma, the cervical spine x-ray is usually interpreted immediately by an emergency doctor such as an Emergency Physician, an Orthopaedic Surgeon, or a General Surgeon involved in the care of the patient. Many different anatomical measurements have been described in the upper cervical spine to date, most of them based on X-ray. doi:10.1016/j.spinee.2006.04.A spinal x-ray can reveal things such as spinal fractures, disk problems, infections, tumors, abnormal curvature of the spine, Scoliosis, arthritis and pretty much anything that may be impacting the spine negatively, including congenital issues that a person may be born with. Classification System Based on Kinematic MR Imaging in Cervical Spondylitic Myelopathy. New MRI Grading System for the Cervical Canal Stenosis. The Torg-Pavlov Ratio for the Prediction of Acute Spinal Cord Injury After a Minor Trauma to the Cervical Spine. Aebli N, Wicki A, Rüegg T, Petrou N, Eisenlohr H, Krebs J. The Reliability of Ratios of Anatomical Measurements. Normal physiology curvature of cervical vertebra is an important factor to maintain effective motor function, and abnormal physiological curvature is one of the symptoms of early cervical spondylosis. Determining the Sagittal Dimensions of the Canal of the Cervical Spine. Cervical Spinal Stenosis: Determination with Vertebral Body Ratio Method. Neurapraxia of the Cervical Spinal Cord with Transient Quadriplegia. Posterior approach laminectomy or laminoplastyĬervical spinal canal stenosis can lead to:Įpidural, subdural, or intradural abscessĭiffuse idiopathic skeletal hyperostosis (DISH)ġ. These two tenets are used to guide decision-making in pursuing conservative or operative management.Īnalgesics including acetaminophen and nonsteroidal anti-inflammatory drugsĪnterior approach discectomy or corporectomy The objective of treatment of cervical spinal stenosis is based on two tenets, which are symptom control and further neurological and functional decline. The Muhle staging system utilizes a special device that facilitates T1- and T2-imaging of the cervical spine in positions from 50° of flexion to 30° of extension 7. The Muhle staging system can also be used to grade cervical spinal canal stenosis. On T2-weighted sagittal images, the Kang grading system can be used to classify cervical spinal canal stenosis based on the severity of spinal cord compression 8. The canal-to-body ratio of Torg and Pavlov can be used to determine the presence of cervical canal stenosis 1-3. Posterior longitudinal ligament ossification The etiology of cervical spinal canal stenosis is divided into congenital or acquired etiologies.Īcquired etiologies can be sub-classified into degenerative, systemic, infectious, traumatic, and iatrogenic etiologies and include 9,10: Chronic compression of the spinal cord results in inflammatory changes and edema and manifests clinically as a progressive decline of upper limb neurological function. It can be associated with vascular compression with arterial involvement resulting in ischemia or venous involvement resulting in stasis. Abnormal BMD and DEXA scan results: T-score on DEXA of 21 to 22.5 5 osteopenia T-score ,22.5 5 osteoporosis Defer to femoral neck T-score over spine T. Intervertebral disc degeneration causing disc herniation and direct compression of the dural sacįacet joint degeneration causing joint instability and hypertrophy, which worsens the degree of dural sac compressionĬapsule and ligament thickening, and osteophytic and cystic changes further worsen the degree of compressionĬervical radiculopathy is caused by cervical canal stenosis at the level where the nerve roots exit the cervical spine and are commonly in the setting of disc herniation and/or facet joint hypertrophy.Ĭervical myelopathy is caused by cervical canal stenosis leading to direct compression of the spinal cord. Weakness of the proximal lower extremitiesĬervical spinal canal stenosis in the setting of age-related degeneration is caused by 9,10: Progressive loss of fine motor function of the handsĭecreased or absent sensation of the arms or hands Patients with cervical spinal canal stenosis may be asymptomatic or present with neurological symptoms predominantly affecting the upper limbs and include 9: Cervical spinal canal stenosis carries a reported prevalence rate of 1 in 1000 persons over 65 years of age and 5 in 1000 persons over the age of 50 in North America.
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