J Korean Soc Spine Surg.  2020 Dec;27(4):125-130. 10.4184/jkss.2020.27.4.125.

Efficacy of Dynamic Radiographs in Routine Evaluations for Degenerative Cervical Spine Disease

Affiliations
  • 1Department of Orthopedic Surgery, Presbyterian Medical Center, Jeon-Ju, Korea
  • 2Department of Orthopedic Surgery, Inje University, Haeundae Paik Hospital, Busan, Korea

Abstract

Study Design Retrospective study.
Objectives
To analyze the usefulness of flexion-extension radiographs in the diagnosis of degenerative cervical disease. Summary of Literature Review There is little information about the efficacy of flexion-extension radiographs in the diagnosis of degenerative cervical disease.
Methods
and Materials We analyzed 1,062 patients with cervical degenerative disease who underwent flexion-extension radiographs and computed tomography (CT) or magnetic resonance imaging (MRI). The range of motion of the cervical joints was measured. Segmental instability was evaluated using the sagittal translation (≥3.5 mm) between C2 and T1, the sagittal angulation (≥3.5°), the vertebral slip angle (≥ 10°), and the dynamic spinal canal stenosis (≤12 mm). The relationship between canal compromise on CT or MRI and radiological instability was also evaluated.
Results
Cervical range of motion was 36.45°±17.63° (range, 2.1°–106.6°). Segmental instability was observed in 484 patients (nine cases of sagittal translation, 79 cases of sagittal plane rotation, 415 cases of a vertical slip angle, and 21 cases of dynamic spinal stenosis). Segmental instability was related with pathology in 218 patients with available CT or MRI (42%, including five cases of sagittal translation, 32 cases of sagittal plane rotation, 171 cases of vertical slip angle, and 10 cases of dynamic spinal stenosis.
Conclusions
Flexion-extension radiographs of the cervical spine were useful in diagnosing and evaluating subaxial segmental instability.

Keyword

Cervical spine disease; Segmental instability; Synamic radiographs
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