Degenerative disease of the cervical spine is common in the US population and causes significant morbidity and expense. Of the patients who ultimately come to surgery (70,000 per year), many have CT-myelography (CTM). an invasive procedure which is expensive and carries some risks. Nearly all of these patients will also have had magnetic resonance imaging (MRI). We propose to use new methods for 3D image fusion to create fused images from MRI scans and plain CT scans (i.e., without myelography) of the neck, potentially saving $15-30 million in healthcare costs per year. We hypothesize that these fused CT-MRI images will be equivalent for both diagnostic and surgical planning purposes to CTM and MRI. This hypothesis will be tested using MRI and plain CT scans from 50 consecutive patients undergoing both CTM and MRI and comparing the diagnoses and surgical plans formulated from the fused images to those formulated using MRI and CTM. Plans and diagnoses will be evaluated by panels of 7 spine surgeons and 4 neuroradiologists, respectively. Statistical evaluation of the systematic differences in plans and diagnoses, if present, will also be performed.
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