Whole-spine dynamic magnetic resonance study of contortionists: anatomy and pathology.
OBJECTIVE
Whole-spine magnetic resonance (MR) images were obtained using a cylindrical 3-T MR imaging system in 5 contortionists to assess the pathological changes possibly associated with the practice of contortion. Whole-spine dynamic MR images were obtained using a 1-T open MR imaging system in 2 of these contortionists with the purpose of defining the range of motion (ROM) achieved during extreme contortion. The range of spinal motion in this unique population was then quantified.


METHODS
The study included 5 female contortionists 20-49 years of age. Imaging was performed using open 1-T and cylindrical 3-T high-field MR imaging systems. Data were viewed and analyzed with DICOM-compliant tools. Real-time, dynamic, and standard MR imaging allowed for quantification of the contortionists' ROM.


RESULTS
There was a difference of 238 degrees between full spinal extension and full flexion. Three of the 5 contortionists had 4 anterosuperior limbus vertebrae at T-11 and the upper lumbar levels.


CONCLUSIONS
Whole-spine dynamic MR imaging is a valuable tool for the evaluation of the extreme ROM in contortionists, allowing for the quantification of extreme mobility. The limbus fractures present in 3 of the 5 contortionists is postulated to be due to avulsion on hyperextension. Future research may open the use of whole-spine dynamic MR imaging into such areas as pain management and traumatic spinal injuries.
Las Vegas Neurosurgery and SpineCare, Las Vegas, Nevada, USA.
Randal R
RR
Peoples
Thomas G
TG
Perkins
Janette W
JW
Powell
Eric H
EH
Hanson
Travis H
TH
Snyder
Timothy L
TL
Mueller
William W
WW
Orrison
D000328:Adult; D002574:Cervical Vertebrae / Q000473:pathology; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000473:pathology; D007405:Intervertebral Disc Displacement / Q000473:pathology / Q000503:physiopathology; D007593:Joint Instability / Q000473:pathology / Q000503:physiopathology; D008141:Lordosis / Q000473:pathology; D008159:Lumbar Vertebrae / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D016059:Range of Motion, Articular / Q000502:physiology; D012600:Scoliosis / Q000473:pathology / Q000503:physiopathology; D013122:Spinal Diseases / Q000473:pathology* / Q000503:physiopathology; D013128:Spinal Osteophytosis / Q000473:pathology / Q000503:physiopathology; D013131:Spine / Q000033:anatomy & histology* / Q000502:physiology; D025241:Spondylarthritis / Q000473:pathology / Q000503:physiopathology; D013177:Sports / Q000502:physiology; D013904:Thoracic Vertebrae / Q000473:pathology; D013997:Time Factors