Effect of neutral position magnetic resonance imaging on cervical discs herniation volume and cervical curvature

doi:10.12307/2024.643

Abstract

Abstract: BACKGROUND: Cervical neutral position magnetic resonance imaging is widely used for the diagnosis and treatment of cervical spondylotic myelopathy. However, it is not possible for patients to maintain the exact same position of the head and neck during repeated cervical magnetic resonance imaging examinations. The cervical spine undergoes minor flexion and extension movements in the sagittal plane, and the head may have a certain degree of variation in flexion and extension. Whether these changes in the neutral position of the cervical spine affect the volume of cervical discs herniation and cervical curvature is unclear.
OBJECTIVE: Using artificial intelligence-assisted measurement, this study aimed to analyze the accuracy and reliability of magnetic resonance imaging examinations for measuring the volume of cervical discs herniation and cervical curvature in patients with cervical spondylotic myelopathy undergoing two consecutive cervical neutral positions in the short term.
METHODS: A retrospective study was conducted on patients with cervical spondylotic myelopathy who underwent conservative treatment and underwent two consecutive cervical magnetic resonance imaging examinations within three months between June 2012 and June 2023. We proposed the use of occipital-thoracic distance and occipital-thoracic angle to evaluate the variation in flexion and extension of the head in the neutral position of the cervical spine. Based on the changes in occipital-thoracic angle, patients were divided into occipital-thoracic angle increase group and occipital-thoracic angle decrease group. Cervical discs herniation volume, C2-6 Cobb angle, and cervical (C3-C7) curvature were measured using artificial intelligence-assisted measurement software. Normal distribution data were represented by mean±SD, while non-normal distribution data were represented by the median (interquartile range). Spearman’s rank correlation coefficient was used to analyze the correlation between changes in Cobb angle, cervical (C3-C7) curvature, and cervical discs herniation volume.
RESULTS AND CONCLUSION: (1) A total of 104 patients and 326 cervical discs herniation were included in the study. There were 47 patients in the occipital-thoracic angle increase group and 57 patients in the occipital-thoracic angle decrease group. (2) Extension and flexion index of the head: There were no significant differences in occipital-thoracic distance and occipital-thoracic angle during the initial diagnosis and follow-up examination. The variation of occipital-thoracic distance was 0.035 (3.23) mm, and the variation of occipital-thoracic angle was -0.31 (3.28)°. The deviation range of occipital-thoracic distance and occipital-thoracic angle was small, and there was no significant correlation. (3) Cervical curvature index: There were no significant differences in C2-6 Cobb angle and C3-C7 curvature during the initial diagnosis and follow-up examination. There were no significant differences in C2-6 Cobb angle and C3-C7 curvature between the occipital-thoracic angle increase group and occipital-thoracic angle decrease group. (4) There was no significant difference in volume of cervical discs herniation during the initial diagnosis and follow-up examination. There was no significant difference in volume of cervical discs herniation between the occipital-thoracic angle increase group and occipital-thoracic angle decrease group. There was no significant correlation between the change of cervical discs herniation volume and the change of C2-6 Cobb angle and the cervical (C3-C7) curvature. (5) These results indicate that in the neutral position of the cervical spine, there were negligible minor flexion and extension movements in the sagittal plane, and the head was limited to a specific position. Although the head has a certain range of flexion and extension variation, it does not affect the accuracy and reliability of parameters including cervical discs herniation volume, C2-6 Cobb angle, and cervical (C3-C7) curvature.

Key words: cervical spondylotic myelopathy, cervical disc herniation, magnetic resonance imaging, neutral cervical position, cervical curvature, artificial intelligence

CLC Number:

Jin Yikai, Ma Zhanhua, Fu Su, Yan Xu, Zhang Chunlin. Effect of neutral position magnetic resonance imaging on cervical discs herniation volume and cervical curvature[J]. Chinese Journal of Tissue Engineering Research, 2024, 28(30): 4860-4865.

Figures/Tables 4

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