Should cervical and lumbar lordosis be evaluated on MR imaging?

Purpose: In the literature, data about the cervical and lumbar lordotic angle measurements and their clinical implications are based on plain film studies. In this study, we aimed to assess the efficacy of magnetic resonance imaging in cervical and lumbar lordotic angle measurements with respect to plain films. Material and Methods: The measurements obtained from plain films and magnetic resonance images of 66 patients with degenerative disease of cervical (n=32) and lumbar (n=34) spine were investigated using the Cobb method (C1-C7 for cervical spine; L1-L5 and L1-S1 for lumbar spine). Intermethod agreement was determined by correlation analysis and the difference between the measurements were evaluated by paired t test. . Results: There was a poor correlation between the two methods (R ≤0.5). A high variability in the measurements, which was most pronounced at the cervical region, was noted. The difference between the plain film and magnetic resonance based measurements were insignificant (p>0.05). Conclusion: Due to poor intermethod agreement, lumbar and servical lordosis measurments on magnetic resonance imaging may be misleading.