Abstract
Objective: Changes in cervical spine flexor muscle size and fat infiltration (FI) may be a useful indicator of disease and injury. However, magnetic resonance (MR) imaging studies show inconsistent results. Therefore, this systematic review aimed to determine whether muscle size or FI is a more sensitive MR measure for detecting changes in cervical flexor muscles in patients with disease or injury compared to healthy controls.
Methods: A systematic literature search was conducted using MEDLINE, Scopus, and Web of Science databases. Eligible studies included those that used MR imaging to measure cervical muscle size and/or FI in adults with disease or injury compared to healthy controls. Data on participant demographics, study methodology, muscle size, and muscle FI were extracted. Methodological quality was assessed using the Newcastle-Ottawa Scale. Meta-analyses were performed using a quality-effects model to evaluate pooled data.
Results: No significant difference was observed between disease/injury and healthy controls for longus colli and capitis muscle cross-sectional area (WMD 1.42, 95% CI –19.46 to 22.29) or FI (WMD 3.02, 95% CI –5.89 to 11.92) when segmented together. When segmented individually, there was a significant decrease in the cross-sectional area between disease/injury and healthy controls for longus colli (WMD –7.77, 95% CI –10.95 to –4.59) and longus capitis (WMD –4.77, 95% CI –7.52 to –2.02).
Conclusion: The segmentation of cervical spine flexor muscles individually compared to together appears to be a more sensitive indicator of disease and injury. The results of this study may explain the inconsistent results of previous studies.