Brain & spine · 2026
Assessing cervical intervertebral disc height on MRI and X-ray versus CT; a single center retrospective cohort study.
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van Santbrink Esther, Boselie Toon, Schuermans Valérie, Krijgsveld Nykle, de Bie Rob, Smeets Anouk, van Santbrink Henk
Аннотация
INTRODUCTION: Cervical intervertebral disc height is often used to score cervical degenerative disc disease (CDDD) and can also aid in pre-operative surgical planning. For this purpose, MRI and X-ray imaging are routinely used. However, the reliability and agreement with computed tomography (CT), the gold standard for linear measurements, remain unknown.
RESEARCH QUESTION: To assess the reliability and agreement of intervertebral disc height measurements between MRI, X-ray, and CT.
MATERIAL AND METHODS: Data was collected from all patients that received an MRI, X-ray, and CT within a timeframe of 6 months at Zuyderland Medical Center (ZMC) between 2014 and 2024. Mid, anterior, and posterior cervical intervertebral disc heights were measured from C2-C3 to C6-C7 in all three imaging modalities. 120 patients were included. The intraclass correlation coefficient (ICC) was calculated for the inter- and intraobserver reliability. A linear mixed model with Bonferroni correction was used to compare outcomes.
RESULTS: ICCs ranged from moderate to excellent for X-ray. ICCs ranged from good to excellent for MRI and CT after sensitivity analysis for equal slice selection. Mean difference in disc height was .1 mm (p = 0.163) between MRI and X-ray, 1.3 mm (p < 0.001) between MRI and CT, and 1.3 mm (p < 0.001) between X-ray and CT.
DISCUSSION AND CONCLUSION: MRI and X-ray exhibit a systematic bias in the measurement of cervical intervertebral disc height when compared to CT. CT should be considered for the assessment of disc height. The mid-disc measurement is recommended to ensure high reliability.
RESEARCH QUESTION: To assess the reliability and agreement of intervertebral disc height measurements between MRI, X-ray, and CT.
MATERIAL AND METHODS: Data was collected from all patients that received an MRI, X-ray, and CT within a timeframe of 6 months at Zuyderland Medical Center (ZMC) between 2014 and 2024. Mid, anterior, and posterior cervical intervertebral disc heights were measured from C2-C3 to C6-C7 in all three imaging modalities. 120 patients were included. The intraclass correlation coefficient (ICC) was calculated for the inter- and intraobserver reliability. A linear mixed model with Bonferroni correction was used to compare outcomes.
RESULTS: ICCs ranged from moderate to excellent for X-ray. ICCs ranged from good to excellent for MRI and CT after sensitivity analysis for equal slice selection. Mean difference in disc height was .1 mm (p = 0.163) between MRI and X-ray, 1.3 mm (p < 0.001) between MRI and CT, and 1.3 mm (p < 0.001) between X-ray and CT.
DISCUSSION AND CONCLUSION: MRI and X-ray exhibit a systematic bias in the measurement of cervical intervertebral disc height when compared to CT. CT should be considered for the assessment of disc height. The mid-disc measurement is recommended to ensure high reliability.