title: Biomechanical aspects of the subarachnoid space and cervical cord in healthy individuals examined with kinematic magnetic resonance imaging.
abstract: METHODS
  In vivo flexion-extension magnetic resonance imaging studies of the cervical spine were performed inside a positioning device.
  
  
  OBJECTIVE
  To determine the functional changes of the cervical cord and the subarachnoid space that occur during flexion and extension of the cervical spine in healthy individuals.
  
  
  BACKGROUND
  As an addition to static magnetic resonance imaging examinations, kinematic magnetic resonance imaging studies of the cervical spine were performed to obtain detailed information about functional aspects of the cervical cord and the subarachnoid space. The results were compared with published data of functional flexion-extension myelograms of the cervical spine.
  
  
  METHODS
  The cervical spines of 40 healthy individuals were examined in a whole-body magnetic resonance scanner from 50 degrees of flexion to 30 degrees of extension, using a positioning device. At nine different angle positions, sagittal T1-weighted spin-echo sequences were obtained. The images were analyzed with respect to the segmental motion, the diameter of the subarachnoid space, and the diameter of the cervical cord.
  
  
  RESULTS
  The segmental motion between flexion and extension was 11 degrees at C2-C3, 12 degrees at C3-C4, 15 degrees at C4-C5, 19 degrees at C5-C6, and 20 degrees at C6-C7. At flexion, a narrowing of the ventral subarachnoid space of up to 43% and a widening of the dorsal subarachnoid space of up to 89% (compared with the neutral position, 0 degrees) were observed. At extension, an increase in the diameter of the ventral subarachnoid space of up to 9% was observed, whereas the dorsal subarachnoid space was reduced to 17%. At flexion, there was a reduction in the sagittal diameter of the cervical cord of up to 14%, and, at extension, there was an increase of up to 15%, compared with the neutral position (0 degrees; these values varied depending on the cervical segment. Statistically significant differences (P < 0.05) were found between flexion and extension in the diameter of the ventral and dorsal subarachnoid space and in the diameter of the cervical cord.
  
  
  CONCLUSIONS
  Compared with the results of previous studies using functional cervical myelograms, kinematic magnetic resonance imaging provides additional noninvasive data concerning the physiologic changes of the cervical subarachnoid space and the cervical cord during flexion and extension in healthy individuals.
authors.affiliation: Department of Diagnostic Radiology, Christian-Albrechts University Kiel, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Muhle
authors.forename: J
authors.initials: J
authors.lastname: Wiskirchen
authors.forename: D
authors.initials: D
authors.lastname: Weinert
authors.forename: A
authors.initials: A
authors.lastname: Falliner
authors.forename: F
authors.initials: F
authors.lastname: Wesner
authors.forename: G
authors.initials: G
authors.lastname: Brinkmann
authors.forename: M
authors.initials: M
authors.lastname: Heller
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000502:physiology; D005260:Female; D006801:Humans; D007596:Joints / Q000502:physiology; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D009192:Myelography; D009334:Neck Muscles / Q000502:physiology; D015588:Observer Variation; D016059:Range of Motion, Articular; D013116:Spinal Cord / Q000502:physiology*; D013346:Subarachnoid Space / Q000502:physiology*