SIGNIFICANCE OF TORG- PAVLOVRATIOANDSPACE AVAILABLE FOR CORD (SAC) ON MRI IN CERVICAL SPONDYLOSIS

Abstract

Background: Cervical spondylosis is a prevalent degenerative condition of the cervical spine, characterized by
progressive structural alterations that result in narrowing of the spinal canal and potential spinal cord compression.
Magnetic resonance imaging (MRI) serves as the modality of choice for evaluating these changes due to its superior softtissue contrast and ability to visualize neural structures. Quantitative indices such as the Torg-Pavlov ratio and Space
Available for Cord (SAC) provide objective metrics for assessing the degree of canal stenosis, yet they remain
underreported in routine radiological practice.
Methods: This prospective observational study included 190 patients with MRI-confirmed cervical spondylosis over an
18-month period. MRI morphometry was performed to measure the sagittal spinal canal diameter, vertebral body diameter,
and spinal cord diameter at the level of maximum stenosis. Torg-Pavlov ratio and SAC were calculated, and clinical
severity was graded. Correlation between imaging parameters and symptom severity was analyzed using Spearman’s
coefficient.
Results: Mean Torg-Pavlov ratios were 0.94 (mild), 0.84 (moderate), and 0.74 (severe). SAC values were 5.8 mm, 4.7
mm, and 3.1 mm, respectively. Both indices correlated inversely with symptom severity (Torg-Pavlov ratio: r = -0.58, p =
0.04; SAC: r = -0.42, p = 0.02). C5-C6 and C3-C4 levels were most frequently involved.
Conclusion: Torg-Pavlov ratio and SAC are reliable morphometric parameters that significantly correlate with clinical
severity in cervical spondylosis. Their routine inclusion in MRI reports can enhance diagnostic accuracy and guide clinical
decision-making.