Torg ratios based on cervical lateral plain films in normal subjects

Main Article Content

David Tjahjadi
MZ Onibala


Stenosis of the spinal canal can be caused by trauma, degenerative processes, and tumors, causing a neurological deficit. If the neurological deficit could be detected or diagnosed earlier, the late complications such as quadriparesis could be prevented. The Torg ratio can be used to find evidence of cervical canal stenosis on lateral plain film, as it has the advantage of not being affected by magnification. The purpose of this study was to determine the Torg ratio for normal subjects using lateral plain films of cervical vertebrae. This cross-sectional study was done at the Department of Radiology FKUI/RSUPN-CM Jakarta, starting from September 16 – 20, 2008. The study included 98 subjects, aged 20 – 40 years, were the mean age of the subjects was 27.4 years (SD ± 5.4). All participants were subjected to measurement of the Torg ratio by cervical lateral plain film. The mean Torg ratio of normal subjects was 0.99 for males and 1.06 for females. The mean Torg ratio of several ethnicities were 1.04 for Javanese, 1.02 for Sundanese, 1.01 for Betawi, and 0.99 for other ethnicities. The mean Torg ratio of our subjects is different from that of other people, such as Pakistanis, Singaporeans, and Koreans. The mean Torg ratios of ethnicities are not significantly different from one another. Therefore, the Torg ratio can be relied upon to predict narrowing of the cervical spinal canal in the sagittal plane.

Article Details

How to Cite
Tjahjadi, D., & Onibala, M. (2010). Torg ratios based on cervical lateral plain films in normal subjects. Universa Medicina, 29(1), 8–13.
Review Article


Tierney RT, Maldjian C, Mattacola CG, Starub SS, Sitler MR. Cervical spine stenosis measures in normal subjects. J Athl Train 2002;37:190-3.

Ilyas M. Dislokasi Interfasetal Bilateral. [Bilateral Interfacetal Dislocation]. J Med Nus 2005;24: 127-34.

Baehr M, Frotscher M. Topical Diagnosis in Neurology 4th ed. Thieme: Stuttgart; 2005.

Pavlov H, Torg JS, Robie B, Jahre C. Cervical spinal stenosis: determination with vertebral body ratio method. Radiology 1987;164:771–5. Cited by Tierney RT, Maldjian C, Mattacola CG, Straub SJ, Sitler MR. Cervical spine stenosis measures in normal subjects. J Athl Train 2002;37:190–3.

Torg JS, Corcoran TA, Thibault LE, Pavlov H, Sennett BJ, Naranja RT Jr, et al. Ccervical cord neurapraxia: classification, pathomechanics, morbidity, and management guidelines. J Neurosurg 1997;87:843-50.

Suk KS, Kim KT, Lee JH, Lee SH, Kim J, Kim JY. Reevaluation of the Pavlov ratio in patients with cervical myelopathy. Clin Orthopaed Surg 2009;1:6-10.

Maqbool A, Athar Z, Hussain L. Midsagittal diameter of cervical spine and Torg’s ratio of the cervical spine in Pakistanis. Pak J Med Sci 2003; 19:203-10.

Lim JK, Wong HK. Variation of the cervical spinal Torg ratio with gender and ethnicity. Spine 2004;4:396–401.

Nadalo LA. Spinal stenosis. Available at: Accessed September 2, 2009.

Bailes GE, Petschauer M, Guskiewicz KM, Marano G. Management of cervical spine injutries in athletes. J Athl Train 2007;42:126-34.

Rao RD, Currier BL, Albert TJ, Bono CM, Marawar SV, Poelstra KA, et al. Degenerative cervical spondylosis: clinical syndromes, pathogenesis, and management. J Bone Joint Surg Am 2007;89:1360-78.

Prasad SS, O’Malley M, Caplan M, Shackleford IM, Pydisetty RK. MRI measurements of the cervical spine and their correlation to Pavlov’s atio. Spine 2003;28:1263-8.

Kelly JD, Aliquo D, Sitler MR, Odgers C, Moyer RA. Association of burners with cervical canal and foraminal stenosis. Am J Sports Med 2000; 28:214-7.

Koyanagi I, Iwasaki Y, Hida K, Akino M, Imamura H, Abe H. Acute cervical cord injury without fracture or dislocation of the spinal column. J Neurosurg 2000;93:15-20.