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Correlation and reliability of cervical sagittal alignment parameters between plain radiographs and multipositional MRI images

Spinal Cord volume 61, pages 307–312 (2023)Cite this article

Subjects

Abstract

Study design

A retrospective study.

Objectives

To assess the validity and reliability of cervical sagittal alignment parameters from multipositional magnetic resonance imaging (MRI) and dynamic cervical radiography.

Setting

Hospital in Suzhou, China.

Methods

Patients who underwent both multipositional MRI and dynamic plain radiography of the cervical spine within a 2-week interval between January 2013 and October 2021 were retrospectively enrolled in this study. The C2–7 angle, C2–7 cervical sagittal vertical axis (C2–7 SVA), T1 slope (T1S), cervical tilt, cranial tilt, and K-line tilt were measured in three different positions (neutral, flexion, and extension) with multipositional MRI and dynamic radiography. Inter- and intraobserver reliabilities were assessed by intraclass correlation coefficients (ICCs). Pearson correlation coefficients were used for statistical analyses.

Results

A total of 65 (30 males and 35 females) patients with a mean age of 53.4 years (range 23–69 years) were retrospectively enrolled in this study. Significant positive correlations were noted regarding all parameters between the plain radiographs and multipositional MRI images. Inter- and intraobserver reliabilities were excellent for all cervical sagittal alignment parameters measured in the two imaging modalities. All cervical sagittal parameters had significant positive correlations with those from multipositional MRI in all three positions (p < 0.05). Pearson correlation coefficients demonstrated moderate and strong correlations between the two examinations.

Conclusions

Cervical sagittal alignment parameters measured on multipositional MRI could reliably substitute for those measured on plain radiographs. Multipositional MRI is a valuable, radiation-free alternative for diagnostic evaluation in degenerative cervical diseases.

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Fig. 1: Cervical plain radiographs and MRI images.
Fig. 2: Cervical alignment measurements.

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Data availability

The data generated or analyzed during this study can be found in the published article.

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Funding

This research is funded by the Suzhou Special Foundation of Clinical Key Diseases Diagnosis and Therapy (LCZX501904).

Author information

Author notes

  1. These authors contributed equally: Zhiqiang Zhou, Fanguo Lin, Yao Zhang.

Authors and Affiliations

  1. Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, China

    Zhiqiang Zhou, Fanguo Lin, Zhigao Jin, Dong Liu, Yekun Deng & Xiaozhong Zhou

  2. Department of Orthopedics, Suqian First Hospital, Suqian, China

    Yao Zhang

  3. Department of Hepatology and Gastroenterology, The Affiliated Infectious Hospital of Soochow University, Suzhou, China

    Xiaotong Wang

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  1. Zhiqiang Zhou
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  4. Zhigao Jin
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  5. Dong Liu
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  6. Yekun Deng
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Zhiqiang Zhou, Fanguo Lin, Yao Zhang, Zhigao Jin, Dong Liu, and Yekun Deng. The first draft of the manuscript was written by Zhiqiang Zhou, Fanguo Lin, and Yao Zhang, reviewed and edited by Xiaotong Wang and Xiaozhong Zhou. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Xiaotong Wang or Xiaozhong Zhou.

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Competing interests

The authors declare no competing interests.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standard of the institutional and/or national research committee and with the 1964 Helsinki declaration and its amendments or comparable ethical standards. This study was ethically approved by the institutional review board of the Second Affiliated Hospital of Soochow University.

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Informed consent was obtained from all individual participants included in the study.

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Patients signed informed consent regarding publishing their data and photographs.

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Zhou, Z., Lin, F., Zhang, Y. et al. Correlation and reliability of cervical sagittal alignment parameters between plain radiographs and multipositional MRI images. Spinal Cord 61, 307–312 (2023). https://doi.org/10.1038/s41393-023-00895-1

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