Cervical canal stenosis

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Cervical canal stenosis can be acquired (e.g. trauma, discs, and ossification of the posterior longitudinal ligament) or congenital.

Radiographic assessment

normal AP diameter is approximately 17 mm.
relative stenosis 10-13 mm.
absolute stenosis <10 mm.

The width of the canal is not however constant, and progressively decreases as one moves down the cervical spine.

C1: 23 mm
C2: 20 mm
C3-C6: 17mm
C7: 15 mm

The canal-to-body ratio of Torg ratioand Pavlov

~~This is a~~The standard method of evaluating cervical canal stenosis was historically the sagital diameter in millimeters, using various cut-offs ¹. In two articles published in 1986 and 1987 ^1,2, Torg and Pavlov introduced the ratio method in order to reduce inter- and intraobserver error caused by variance in magnification and landmarking. This method uses the ratio of the diameter of cervical canal to the width of cervical body~~. Less~~, with a ratio of less than0.8 on lateral view ~~is consistent with~~taken as an indication of cervical stenosis¹.

Pavlov

This ratio

~~Similar~~

is variously referred to as the Torg ratio³, the Pavlov ratio ^{3, relates4}, the Torg-Pavlov ratio ⁵, or the canal-vertebral body width (how does this differ??) and should be approximately 1.0. Less than 0.85 indicates stenosis, and again less than 0.80 is a significant risk factor for neurologic injury in relatively minor trauma-to-body ratio ³.

-</ul><h5>Torg ratio</h5>This is a the ratio of the diameter of cervical canal to the width of cervical body. Less than 0.8 on lateral view is consistent with cervical stenosis.<h5>Pavlov ratio</h5>Similar to Torg ratio, relates canal-vertebral body width (how does this differ??) and should be approximately 1.0. Less than 0.85 indicates stenosis, and again less than 0.80 is a significant risk factor for neurologic injury in relatively minor trauma.
+</ul><h5>The canal-to-body ratio of Torg and Pavlov</h5>The standard method of evaluating cervical canal stenosis was historically the sagital diameter in millimeters, using various cut-offs 1. In two articles published in 1986 and 1987 1,2 , Torg and Pavlov introduced the ratio method in order to reduce inter- and intraobserver error caused by variance in magnification and landmarking. This method uses the ratio of the diameter of cervical canal to the width of cervical body, with a ratio of less than 0.8 on lateral view taken as an indication of cervical stenosis 1.This ratio is variously referred to as the Torg ratio 3, the Pavlov ratio 3, 4, the Torg-Pavlov ratio 5, or the canal-to-body ratio 3.

References changed:

3. Blackley H, Plank L, Robertson P. Determining the Sagittal Dimensions of the Canal of the Cervical Spine. The Reliability of Ratios of Anatomical Measurements. J Bone Joint Surg Br. 1999;81(1):110-2. <a href="https://doi.org/10.1302/0301-620x.81b1.9001">doi:10.1302/0301-620x.81b1.9001</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/10068016">Pubmed</a>
4. Lee M, Cassinelli E, Riew K. Prevalence of Cervical Spine Stenosis. Anatomic Study in Cadavers. J Bone Joint Surg Am. 2007;89(2):376-80. <a href="https://doi.org/10.2106/JBJS.F.00437">doi:10.2106/JBJS.F.00437</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/17272453">Pubmed</a>
5. Aebli N, Wicki A, Rüegg T, Petrou N, Eisenlohr H, Krebs J. The Torg-Pavlov Ratio for the Prediction of Acute Spinal Cord Injury After a Minor Trauma to the Cervical Spine. Spine J. 2013;13(6):605-12. <a href="https://doi.org/10.1016/j.spinee.2012.10.039">doi:10.1016/j.spinee.2012.10.039</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/23318107">Pubmed</a>
6. Kang Y, Lee J, Koh Y et al. New MRI Grading System for the Cervical Canal Stenosis. AJR Am J Roentgenol. 2011;197(1):W134-40. <a href="https://doi.org/10.2214/AJR.10.5560">doi:10.2214/AJR.10.5560</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/21700974">Pubmed</a>
1. Torg J, Pavlov H, Genuario S et al. Neurapraxia of the Cervical Spinal Cord with Transient Quadriplegia. J Bone Joint Surg Am. 1986;68(9):1354-70. - <a href="https://www.ncbi.nlm.nih.gov/pubmed/3782207">Pubmed</a>
2. Pavlov H, Torg J, Robie B, Jahre C. Cervical Spinal Stenosis: Determination with Vertebral Body Ratio Method. Radiology. 1987;164(3):771-5. <a href="https://doi.org/10.1148/radiology.164.3.3615879">doi:10.1148/radiology.164.3.3615879</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/3615879">Pubmed</a>
1. Kang Y, Lee JW, Koh YH et-al. New MRI grading system for the cervical canal stenosis. AJR Am J Roentgenol. 2011;197 (1): W134-40. <a href="http://dx.doi.org/10.2214/AJR.10.5560">doi:10.2214/AJR.10.5560</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/21700974">Pubmed citation</a>
2. Lee MJ, Cassinelli EH, Riew KD. Prevalence of cervical spine stenosis. Anatomic study in cadavers. J Bone Joint Surg Am. 2007;89 (2): 376-80. <a href="http://dx.doi.org/10.2106/JBJS.F.00437">doi:10.2106/JBJS.F.00437</a> - <a href="http://www.ncbi.nlm.nih.gov/pubmed/17272453">Pubmed citation</a>

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Cervical canal stenosis

Updates to Article Attributes

Radiographic assessment

The canal-to-body ratio of Torg ratioand Pavlov

Pavlov

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