Date of Award

12-21-2009

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Jonathan Grauer MD

Second Advisor

Peter G. Whang MD

Abstract

Cervical oblique radiographs are often obtained to evaluate the patency of the intervertebral foramina. Previous work has demonstrated that computed tomography(CT), particularly oblique reconstructions of the spine, allows for the accurate measurement of foramina1 dimensions. Although oblique radiographs are routinely ordered by practitioners for this reason, there are currently no studies that have directly compared these measurements to those derived from CT scans. The purpose of this study was to establish any correlation between the dimensions of cervical foramina assessed from oblique radiographs to those observed on CT scans. Radiographs of four fresh-frozen cadaveric cervical spine specimens were obtained at an angle of 50 degrees. Using digital measurement tools, the foramina1 height, width and cross-sectional area were calculated at each level between C2-C3 and C7-T1. CT scans were subsequently performed so that these values could also be acquired from 50 degree oblique reconstructions. Statistical analyses revealed excellent inter-observer reliabilities for radiographs and CT scans (ICC 0.91 and 0.99 for height, 0.90 and 0.97 for width, and 0.84 and 0.92 for area). For the two imaging modalities, the Pearson correlation coefficients for height, width, and area were 0.439, 0.871, and 0.899; which corresponds to a moderate correlation for height and strong correlations for width and area. The only significant differences (p<0.05) between CT and radiograph measurements were for height at the C6/C7 and C7/T1, for width at the C5/6, and for area at the C2/3. Based on these findings, we believe that oblique radiographs provide reasonably accurate estimates of intervertebral foraminal dimensions for the initial evaluation of the cervical spine.

Comments

This is an Open Access Thesis.

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