Dynamic changes of the spinal canal in patients with cervical spondylosis at flexion and extension using magnetic resonance imaging.
OBJECTIVE
The authors determine the dynamic changes of the spinal canal during flexion and extension in patients with cervical spondylosis.


METHODS
Forty-six patients were studied inside a whole-body magnetic resonance (MR) scanner with between 50 degrees of flexion and 30 degrees of extension, using a positioning device. At neutral position (0 degree) and maximum flexion and extension sagittal T2-weighted turbo spin echo sequences were acquired.


RESULTS
A significant (P < or = 0.05) increase of spinal stenosis was found at extension (48%, 22 of 46 patients) when compared with flexion (24%, 11 of 46). Cervical cord compression was diagnosed at flexion in 5 patients (11%) and at extension in 9 patients (20%). Concerning the number of patients with cervical cord compression at flexion and extension, significant differences (P < or = 0.05) were found in patients with degenerative changes at four segments compared with patients with one segment involvement.


CONCLUSIONS
Magnetic resonance imaging identified a significant percentage of increased spinal stenosis at flexion and, especially, at extension, which was not observed at neutral position (0 degree). Flexion and extension MR imaging demonstrates additional information using a noninvasive technique concerning the dynamic factors in the pathogenesis of cervical spondylotic myelopathy.
Department of Diagnostic Radiology, Christian-Albrechts-University Kiel, Germany.
C
C
Muhle
D
D
Weinert
A
A
Falliner
J
J
Wiskirchen
J
J
Metzner
M
M
Baumer
G
G
Brinkmann
M
M
Heller
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009068:Movement; D013115:Spinal Canal / Q000473:pathology* / Q000503:physiopathology; D013117:Spinal Cord Compression / Q000175:diagnosis / Q000209:etiology; D013128:Spinal Osteophytosis / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D013130:Spinal Stenosis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology