Reliability of evaluating C2-7 Cobb angle for cervical degenerative disease with unclear C7 vertebrae on X-ray, CT and MRI

doi:10.3969/j.issn.2095-4344.0334

Abstract

Abstract:

BACKGROUND: In some patients with cervical degenerative disease, C₇ is unclear on the cervical lateral films due to anatomical position, which severely affects the measurement accuracy of C_2-7 Cobb angle.

OBJECTIVE: To explore whether CT and MRI can be used to evaluate sagittal alignment of cervical spine as the substitute of X-ray in patients with unclear C₇ vertebrae.

METHODS: Eighty-two eligible patients undergoing lumbar surgeries were included. Based on the C₇ revealed on the X-ray, there were 28 patients with unclear C₇ vertebrae (group A), and 54 patients with clear C₇ vertebrae (group B). The cervical sagittal morphology on X-ray, CT and MRI was evaluated by C_2-7Cobb angle. Paired-t test, intra-class correlation coefficient and Pearson correlation coefficient were used to analyze the difference, reliability and correlation of sagittal alignment on X-ray, CT and MRI.

RESULTS AND CONCLUSION: (1) C_2-7 Cobb angles measured on CT and MRI were significantly lower than those on X-ray (P < 0.05). The reliability of measurement on X-ray in the Group A was found to be obviously lower than that on CT and MRI (ICC=0.768, 0.977, 0.986), while the reliability of measurement on X-ray in the Group B was similar to that on CT and MRI (ICC=0.953, 0.976, 0.977). (2) Correlation analysis showed that the C_2-7Cobb angles measured on CT and MRI were highly correlated with those on X-ray (r=0.569, P < 0.05; r=0.670, P < 0.05). (3) The formulations were calculated as follow: C_2-7 Cobb angle (CT)=0.60×C_2-7 Cobb angle (X-ray)-6.78°; C_2-7Cobb angle (MRI)=0.70×C_2-7 Cobb angle (X-ray)-0.30°. (4) In summary, CT and MRI can avoid the inference of unclear C₇ vertebrae, and can be used to evaluate the sagittal alignment of cervical spine as the replacement of X-ray.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Cervical Vertebrae, Intervertebral Disk Degeneration, Tissue Engineering

CLC Number:

R318

Wu Tao, Liu Jun, Wang Gang . Reliability of evaluating C_2-7Cobb angle for cervical degenerative disease with unclear C₇ vertebrae on X-ray, CT and MRI [J]. Chinese Journal of Tissue Engineering Research, 2018, 22(31): 4993-4997.

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Reliability of evaluating C_2-7Cobb angle for cervical degenerative disease with unclear C₇ vertebrae on X-ray, CT and MRI

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