OBJECTIVE: To compare CR with CT (static and dynamic) to evaluate upper spine instability and to determine if CT in flexion adds value compared to MR imaging in neutral position to assess compression of the subarachnoid space and of the spinal cord. MATERIALS AND METHODS: Twenty-one consecutive patients with atlantoaxial subluxation due to rheumatoid arthritis planned for atlantoaxial fusion were included. CT and MRI were performed with the neck in the neutral position and CT also in flexion. CR in neutral position and flexion were obtained in all patients except for one subject who underwent examination in flexion and extension. RESULTS: CR and CT measurements of atlantoaxial subluxation correlated but were larger by CR than CT in flexion, however, the degree of vertical dislocation was similar with both techniques irrespective of the position of the neck. Cervical motion was larger at CR than at CT. The spinal cord compression was significantly worse at CT obtained in the flexed position as compared to MR imaging in the neutral position. CONCLUSIONS: Functional CR remains the primary imaging method but CT in the flexed position might be useful in the preoperative imaging work-up, as subarachnoid space involvement may be an indicator for the development of neurologic dysfunction.
OBJECTIVE: To compare CR with CT (static and dynamic) to evaluate upper spine instability and to determine if CT in flexion adds value compared to MR imaging in neutral position to assess compression of the subarachnoid space and of the spinal cord. MATERIALS AND METHODS: Twenty-one consecutive patients with atlantoaxial subluxation due to rheumatoid arthritis planned for atlantoaxial fusion were included. CT and MRI were performed with the neck in the neutral position and CT also in flexion. CR in neutral position and flexion were obtained in all patients except for one subject who underwent examination in flexion and extension. RESULTS:CR and CT measurements of atlantoaxial subluxation correlated but were larger by CR than CT in flexion, however, the degree of vertical dislocation was similar with both techniques irrespective of the position of the neck. Cervical motion was larger at CR than at CT. The spinal cord compression was significantly worse at CT obtained in the flexed position as compared to MR imaging in the neutral position. CONCLUSIONS: Functional CR remains the primary imaging method but CT in the flexed position might be useful in the preoperative imaging work-up, as subarachnoid space involvement may be an indicator for the development of neurologic dysfunction.
Authors: Per Svedmark; Fredrik Lundh; Gunnar Németh; Marilyn E Noz; Gerald Q Maguire; Michael P Zeleznik; Henrik Olivecrona Journal: Acta Radiol Date: 2011-10-17 Impact factor: 1.990
Authors: Y P M Goekoop-Ruiterman; J K de Vries-Bouwstra; C F Allaart; D van Zeben; P J S M Kerstens; J M W Hazes; A H Zwinderman; H K Ronday; K H Han; M L Westedt; A H Gerards; J H L M van Groenendael; W F Lems; M V van Krugten; F C Breedveld; B A C Dijkmans Journal: Arthritis Rheum Date: 2005-11
Authors: E William St Clair; Désirée M F M van der Heijde; Josef S Smolen; Ravinder N Maini; Joan M Bathon; Paul Emery; Edward Keystone; Michael Schiff; Joachim R Kalden; Ben Wang; Kimberly Dewoody; Roberta Weiss; Daniel Baker Journal: Arthritis Rheum Date: 2004-11