Document Detail

The optimal radiologic method for assessing spinal canal compromise and cord compression in patients with cervical spinal cord injury. Part I: An evidence-based analysis of the published literature.
MedLine Citation:
PMID:  10101828     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: An evidence-based analysis of published radiologic criteria for assessing spinal canal compromise and cord compression in patients with acute cervical spinal cord injury. OBJECTIVES: This study was conducted to determine whether literature-based guidelines could be established for accurate and objective assessment of spinal canal compromise and spinal cord compression after cervical spinal cord injury. SUMMARY OF BACKGROUND DATA: Before conducting multicenter trials to determine the efficacy of surgical decompression in cervical spinal cord injury, reliable and objective radiographic criteria to define and quantify spinal cord compression must be established. METHODS: A computer-based search of the published English, German, and French language literature from 1966 through 1997 was performed using MEDLINE (U.S. National Library of Medicine database) to identify studies in which cervical spinal canal and cord size were radiographically assessed in a quantitative manner. Thirty-seven references were included for critical analysis. RESULTS: Most studies dealt with degenerative disease, spondylosis, and stenosis; only 13 included patients with acute cervical spinal cord injury. Standard lateral radiographs were the most frequent imaging method used (23 studies). T1- and T2-weighted magnetic resonance imaging were used to assess spinal cord compression in only 7 and 4 studies, respectively. Spinal cord size or compression were not precisely measured in any of the cervical trauma studies. Interobserver or intraobserver reliability of the radiologic measurements was assessed in only 7 (19%) of the 37 studies. CONCLUSIONS: To date, there are few quantitative, reliable radiologic outcome measures for assessing spinal canal compromise or cord compression in patients with acute cervical spinal cord injury.
S C Rao; M G Fehlings
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  Spine     Volume:  24     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-07-15     Completed Date:  1999-07-15     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  598-604     Citation Subset:  IM    
Division of Neurosurgery and Spinal Program, University of Toronto, Toronto Hospital-Western Division, Ontario, Canada.
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MeSH Terms
Cervical Vertebrae / radiography
Sensitivity and Specificity
Spinal Canal / injuries,  radiography*
Spinal Cord Compression / etiology,  radiography*
Spinal Cord Injuries / complications,  radiography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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