Spinolaminar Line Test as a Screening Tool for C1 Stenosis

Area of Science:

• Neurosurgery
• Radiology
• Orthopedics

Background:

• Stenosis of the C1 space available for the cord (SAC) can lead to serious neurological deficits.
• Accurate and efficient screening tools are crucial for early detection of C1 SAC stenosis.

Purpose of the Study:

• To evaluate the sensitivity and specificity of the C3-C2 spinolaminar line test.
• To determine its utility as a screening tool for C1 SAC stenosis.

Main Methods:

• Retrospective cohort study of 487 patients.
• Radiographic measurement of C1 SAC and assessment of the C3-C2 spinolaminar line.
• Confirmation with CT and MRI for precise C1/C2 SAC diameters and spinal cord compression.

Main Results:

• The spinolaminar line test was positive in 4.3% of patients (21/487).
• All positive tests correlated with C1 SAC ≤ 19.4 mm.
• The test demonstrated 100% sensitivity and 97% specificity for identifying C1 SAC smaller than C2 on CT.

Conclusions:

• The C3-C2 spinolaminar line test is a highly sensitive and specific screening tool for C1 stenosis.
• It can effectively identify patients requiring further investigation for potential C1 SAC stenosis.