Oral Presentation Sydney Spinal Symposium 2025

Assessment of Cervical Cord Compression using Whole Spine Sagittal MRI Sequences: A Missed Opportunity in Spinal Imaging? (124857)

Rohil V Chauhan 1 2 , Anand H Segar 1 3 4 , Ciaran Regan 2 , David Rice 2 5 , Steven G White 2
  1. Auckland Spine Surgery Centre, Royal Oak, AUCKLAND, New Zealand
  2. Auckland University of Technology, Auckland, New Zealand
  3. Orthopaedics, Auckland City Hospital, Auckland, New Zealand
  4. Faculty of Medical and Health Sciences, Surgery, The University of Auckland, Auckland, New Zealand
  5. Department of Anaesthesiology and Perioperative Medicine, North Shore Hospital, Auckland, New Zealand

Introduction
T2-weighted whole spine sagittal MRI (T2-WSSMRI) is frequently acquired alongside thoracolumbar MRI for vertebral segmentation but may also incidentally identify cervical cord compression (CCC)—a key risk factor for degenerative cervical myelopathy (DCM). This review aimed to evaluate the prevalence of CCC using T2-WSSMRI across clinical studies applying reproducible grading criteria.

Materials/Methods

A systematic review was conducted following PRISMA guidelines and registered on PROSPERO (CRD42024524243). Five databases (MEDLINE, CINAHL, AMED, SPORTDiscus, Scopus) were searched for studies reporting the prevalence of T2-WSSMRI-identified CCC in adult patients undergoing thoracolumbar MRI. Studies not utilising a CCC grading system, non-original research, included non-degenerative conditions, or not available in the English language were excluded.

Screening and full-text review were independently performed by two reviewers. Risk of bias was assessed using a 7-item tool adapted from Hoy et al, (2012); methodological quality was appraised using the JBI Prevalence Critical Appraisal Tool. Due to heterogeneity in CCC grading thresholds, meta-analysis was not performed. Prevalence and subgroup estimates were reported descriptively.

Results

Of 476 screened articles and 40 full texts reviewed, six studies (n=2633; mean age 56.9) were included. All six studies were retrospective cross-sectional studies conducted in tertiary orthopaedic or neurosurgical departments (4/6 from Korea). The pooled CCC prevalence was 14.2% (n=375). This rose to 23.9% amongst the three studies including patients with LSS (total n=725) and further to 28.3% in three studies including patients ≥60 years (total n=653).

Three studies reported clinical symptoms in CCC-positive cases (total n=147), whereby 32% (n=47) had clinical features of myelopathy. All studies had a low risk of bias and moderate-to-high methodological quality.

Conclusion

T2-WSSMRI may serve as a pragmatic screening tool for CCC, particularly in older adults and those with LSS, which represent at-risk groups for tandem spinal pathology. Further prospective studies are needed to establish reliability and accuracy.