Static and dynamic CT imaging of the cervical spine in patients with rheumatoid arthritis.

Abstract:

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.

journal_name

Skeletal Radiol

journal_title

Skeletal radiology

authors

Söderman T,Olerud C,Shalabi A,Alavi K,Sundin A

doi

10.1007/s00256-014-2000-9

subject

Has Abstract

pub_date

2015-02-01 00:00:00

pages

241-8

issue

2

eissn

0364-2348

issn

1432-2161

journal_volume

44

pub_type

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