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Chiropractic Research Review

Disc Measurement Reliability on Cervical MRI

MRI scans are often used to evaluate disc displacement after spinal manipulation, but most of this information pertains to the lumbar spine and does not involve scans of disc displacement prior to manipulation for comparison.

Generalized data on disc herniations, displacement, and size in the asymptomatic population could be beneficial for future MRI interpretation; the accuracy of chiropractic radiologists at assessing MRI scans of cervical discs should also be determined.

The goals of this study were to identify preliminary data on the cervical spine in asymptomatic individuals; determine average measurements for normal and displaced cervical discs; and assess reliability of measurements by chiropractic radiologists. Three chiropractic radiologists evaluated 106 MRI scans; interobserver reliability was then measured. Next, 37 scans were reassessed by each radiologist at least two weeks later following a "washout time" to evaluate intraobserver accuracy.

Results: Interexaminer and intra- examiner reliability with the three examiners was "good" to "very good." There were distinct size differences between normal discs and between different forms of disc displacement. Ruler and digitizer measurements of disc features were virtually the same. Overall, measurements of spinal discs were more accurate and consistent for the cervical spine than on lumbar discs in a previous, related study with a similar design.

"Understanding the natural history of cervical disk degeneration is helpful in making clinical determinations relating to the significance and treatment of different types of disk displacements," the authors conclude.

Cooley JR, Danielson CD, Schultz GD, et al. Posterior disk displacement: Morphologic assessment and measurement reliability - cervical spine. Journal of Manipulative and Physiological Therapeutics 2001:24(9), pp. 560-568.

Chiropractic Research Review

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