The relationship between spinal stenosis and neurological outcome in traumatic cervical spine injury: an analysis using Pavlov's ratio, spinal cord area, and spinal canal area.
BACKGROUND
This study examined the relationship between four radiological parameters (Pavlov's ratio, sagittal diameter, spinal cord area, and spinal canal area) in patients with a traumatic cervical spine injury, as well as the correlation between these parameters and the neurological outcome.


METHODS
A total of 212 cervical spinal levels in 53 patients with a distractive-extension injury were examined. The following four parameters were measured: Pavlov's ratio on the plain lateral radiographs, the sagittal diameter, the spinal cord area, and the spinal canal area on the MRI scans. The Pearson correlation coefficients between the parameters at each level and between the levels of each parameter were evaluated. The correlation between the radiological parameters and the spinal cord injury status classified into four categories, A (complete), B (incomplete), C (radiculopathy), and D (normal) was assessed.


RESULTS
The mean Pavlov's ratio, sagittal diameter, spinal cord area and spinal canal area was 0.84, 12.9 mm, 82.8 mm(2) and 236.8 mm(2), respectively. An examination of the correlation between the radiological spinal stenosis and clinical spinal cord injury revealed an increase in the values of the four radiological parameters from cohorts A to D. Pavlov's ratio was the only parameter showing statistically significant correlation with the clinical status (p = 0.006).


CONCLUSIONS
There was a correlation between the underlying spinal stenosis and the development of neurological impairment after a traumatic cervical spine injury. In addition, it is believed that Pavlov's ratio can be used to help determine and predict the neurological outcome.
Song
Kyung-Jin
KJ
Department of Orthopedic Surgery, College of Medicine, Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea.
Choi
Byung-Wan
BW
Kim
Sul-Jun
SJ
Kim
Gyu-Hyung
GH
Kim
Young-Shin
YS
Song
Ji-Hun
JH
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019838:Neck Injuries / Q000000981:diagnostic imaging*; D011859:Radiography; D012189:Retrospective Studies; D013115:Spinal Canal / Q000000981:diagnostic imaging* / Q000473:pathology; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging* / Q000473:pathology; D013130:Spinal Stenosis / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult