title: A novel approach to quantitatively assess posttraumatic cervical spinal canal compromise and spinal cord compression: a multicenter responsiveness study.
abstract: METHODS
  Multicenter retrospective study.
  
  
  OBJECTIVE
  To examine whether posttraumatic cervical spinal canal compromise and spinal cord compression are responsive to changes in motor and sensory functions.
  
  
  BACKGROUND
  The maximum canal compromise (MCC) and maximum spinal cord compression (MSCC) were developed to quantitatively assess canal stenosis and spinal cord compression using computed tomographic (CT) scan and magnetic resonance imaging (MRI) in the setting of acute spine trauma.
  
  
  METHODS
  We included 100 consecutive patients with acute spine trauma. Patients were classified into three groups as follows: patients with acute spine trauma without spinal cord injury (group 1), patients with incomplete spinal cord injury (group 2), and patients with complete spinal cord injury (group 3). We studied three quantitative imaging parameters given as follows: MCC using CT-based measurements, MCC using T1-MRI based measurements, and MSCC using T2-MRI based measurements.
  
  
  RESULTS
  There were 78 male patients and 22 female patients with ages from 17 to 82 years (mean age = 45 years). In group 1, there were no significant differences regarding the mean MRI-MCC and MSCC among the spine levels. Although most spine levels were statistically comparable regarding the CT-MCC in patients of group 1, the C7 level significantly differed from the C3 level. Comparisons among all three patient groups showed significant differences regarding the mean MRI-MCC and MSCC, but no significant differences were observed in the mean CT-MCC between groups 1 and 2, and between groups 1 and 3. Data analyses using operating characteristics of each radiologic parameter indicated that only the MRI parameters had consistently optimal cutoff points to distinguish between groups 1 and 2, and between groups 2 and 3.
  
  
  CONCLUSIONS
  Our results suggest that the MRI-based measurements of canal compromise and spinal cord compression are responsive to changes in motor and sensory functions. However, the MCC using CT-based measurements provides inconsistent results that can result in misdiagnosis in the clinical setting.
authors.affiliation: Division of Genetics and Development, Toronto Western Research Institute, University Health Network, Toronto, Canada. jfurlan@uhnres.utoronto.ca
authors.forename: Julio C
authors.initials: JC
authors.lastname: Furlan
authors.forename: Ahilan
authors.initials: A
authors.lastname: Kailaya-Vasan
authors.forename: Bizhan
authors.initials: B
authors.lastname: Aarabi
authors.forename: Michael G
authors.initials: MG
authors.lastname: Fehlings
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013115:Spinal Canal / Q000293:injuries / Q000473:pathology* / Q000503:physiopathology; D013117:Spinal Cord Compression / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D013124:Spinal Injuries / Q000150:complications / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D015599:Trauma Severity Indices; D055815:Young Adult