[Value of kinematic MRI in the evaluation of patients with exacerbated pain in cervical spine motion compared with static MRI].
OBJECTIVE
To assess the clinical value of kinematic MR imaging in patients with cervical radiculopathy and increasing symptoms after provocative maneuvers at flexion, extension, axial rotation and coupled motion of the cervical spine.


METHODS
Thirty-five patients with cervical disc herniation or cervical spondylosis in whom symptoms were elicited at flexion, extension, axial rotation and coupled motion were studied inside a positioning device using T2-weighted TSE, 2D-FLASH, and reformatted 3D DESS and 3D-FISP sequences. The images were evaluated for the size of disc herniations, the foraminal size and cervical cord displacement at provocative position compared with neutral position (0 degree). In addition, the value of kinematic MR images were interpretated with regard to changes in the therapeutic procedure and intraoperative patient positioning.


RESULTS
Compared with the neutral position (0 degree) a change in disc herniations was not found in any (0%) of the provocative positions. In five patients (14%) cervical cord displacement was noted at axial rotation. The foraminal size varied depending on the provocative position, increasing at flexion and decreasing at extension.


CONCLUSIONS
Kinematic MR imaging in patients with cervical radiculopathy and increasing symptoms at provocative maneuvers provides no additional information for the therapeutic decision-making process.
Muhle
C
C
Klinik für Nuklearmedizin, Christian-Albrechts-Universität zu Kiel.
Brossmann
J
J
Biederer
J
J
Grimm
J
J
Mohr
A
A
Heller
M
M
D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000473:pathology*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009068:Movement; D010148:Intractable Pain / Q000209:etiology*; D012399:Rotation; D013128:Spinal Osteophytosis / Q000175:diagnosis* / Q000503:physiopathology