The Assessment of Upright Cervical Spinal Alignment Using Supine MRI Studies

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Study Design:This is a prospective, single-centre study.Objective:The purpose of this study is researching whether there is a correlation or not between the cervical alignment in the examinations of magnetic resonance imaging (MRI) in lying position and the alignment in the cervical direct radiography and whether the cervical alignment in standing position could be estimated or not through MRI measurements in the supine position.Summary of Background Data:Cervical spinal alignment is a parameter required for deciding the surgical procedure particularly in patients with cervical myelopathy and deformity. However, cervical alignment angles change according to lying and standing positions. Therefore, the direct standing radiograph is taken as basis for this examination.MethodsCervical alignments were measured with 3 different methods with the standing lateral radiographies and lying MRI of 51 patients with cervical disorder.Results:A high correlation was found between the measurements in standing and lying positions for the spinal alignments measured through the Cobb angle and posterior tangent method. It was found that standing Cobb angle (in plain graphy)=Cobb angle (in MRI)×0.489+7.13 and posterior tangent angle (in plain graphy)=posterior tangent angle (in MRI)×0.54+9.37.Conclusions:It is possible to estimate the spinal alignment in standing position with the measurements of cervical spinal alignment in the MRI at supine position. And this may render having cervical graphy in standing position unnecessary.

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