![]() There was a significant difference in the CXA values between neck extended and neck flexed positions but not between supine and prone positions.Ĭlivoaxial angle basilar invagination flexion-extension. We report normal ranges for CXA in various neck positions based on 3D T2-weighted MRI, using a reproducible measurement method. o ur results showed there were no statistical angular differences among five spinal levels in either flexion or extension, except for the comparison between C2/3 (13.5) and C4/5 (22.6) angles. ![]() Concordant correlations of reader measurements showed substantial agreement in the supine position at 0.96, with lower agreement in the prone position at 0.87. A total of 1,120 image sequences were analyzed for 56 healthy adult subjects by a precise image protocol during cervical flexion and extension. The mean value for extension CXA was 169.20° ( SD=5.81°), and the mean value for flexion CXA was 144.73° ( SD=5.71°), the difference being statistically significant ( p<0.0001) regardless of supine or prone position. Dynamic MR imaging of the cervical spine, however, showed spinal cord compression on. Statistical analysis was performed in all positions and included mean CXA, range, standard deviation ( SD), inter-reader agreement, and group comparisons. Flexion-extension plain radiographs of the spine showed no instability. C3/C4 and C6/C7 allow for the most movement in this plane of motion. CXA is strictly defined as the angle between a line along the inferior third of the dorsal clival cortex and a line from the superior/posterior cortex of the dens to the posterior/inferior corner of the C2 body. Lateral flexion range of motion is normally close to 30 degrees. The CXA was measured in 10 healthy volunteers on sagittal T2 SPACE c-spine MRI in supine and prone positions and with the neck both neck and extended. The aim of this study was to use high-resolution MRI to determine the normal range of CXA in various neck positions using a reproducible measurement technique. Published normal ranges of CXA using x-ray, computed tomography, or magnetic resonance imaging (MRI) vary dramatically, especially with neck flexion or extension. ![]() An abnormally decreased clivoaxial angle (CXA) is used during the clinical evaluation for corrective skull base surgery. Functional radiographic diagnosis of the cervical spine: flexion/extension.
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