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Journal of Craniovertebral Junction and Spine
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ORIGINAL ARTICLE
Year : 2019  |  Volume : 10  |  Issue : 4  |  Page : 240-246

Impact of imaging modality, age, and gender on craniocervical junction angles in adults without structural pathology


1 Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York Presbyterian Hospital, New York, NY, USA
2 Department of Paediatric Surgery and Transplant, Orthopaedic Unit, Bambino GesÙ Children's Hospital, Rome, Italy
3 Department of Healthcare Policy and Research, Division of Biostatistics and Epidemiology, Weill Cornell Medicine, New York, NY, USA
4 Department of Radiology, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY, USA

Correspondence Address:
Dr. Ibrahim Hussain
Department of Neurological Surgery, Weill Cornell Brain and Spine Center, New York Presbyterian Hospital, 525 East 68th Street, Box 99, New York, NY 10065
USA
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcvjs.JCVJS_125_19

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Context: Multiple angles of the craniocervical junction (CCJ) are associated with pathological conditions and surgical outcomes, including the clivo-axial angle (CXA), clival slope (CS), and sagittal axis (XS). However, there are varying normative ranges reported and a paucity of data analyzing the effects of imaging modality, age, and gender on these angles. Setting and Design: A retrospective review of computed tomographic (CT) and magnetic resonance imaging (MRI) scans in fifty adults without CCJ pathology from 2014 to 2019. Methods: Age, gender, indication, and hours between scans were recorded. Two-blinded observers measured all angles. Analysis between angles from the same patient was performed using the Wilcoxon signed-rank test. Multivariable linear regression was used to test for associations between average angles and age or gender. Results: Average age and time between scans were 41.3 and 14.3 h, respectively, with 94% performed due to trauma. On CT, average CXA, CS, and XS were 162.1°, 118.4°, and 81.3°, respectively. On MRI, they were 159.8°, 117.2°, 85.3°, respectively. There were statistically significant differences between CXA and XS (P < 0.01) based on imaging modality. On CT, there was a significant increase in XS by 1.93°° and decrease in CS by 1.88°° and on MRI, there was a significant increase in CXA by 1.93°° and decrease in CS by 2.75°° corresponding with a 10-year advancement of age. Gender did not have an effect. Conclusion: There are significant differences in angular measurements of the CCJ between CT and MRI from the same patient, as well as changes in normative values based on age.


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