title: Kinematic magnetic resonance imaging to define the cervical facet joint space for the spine in neutral and torsion.
abstract: METHODS
  Prospectively acquire magnetic resonance images of the neck in normal subjects and patients with radiculopathy to measure and compare measures of the facet joint space thickness and volume.
  
  
  OBJECTIVE
  The goal was to determine whether there is any difference in facet joint architecture between the 2 populations with the head in each of neutral and pain-eliciting rotation.
  
  
  BACKGROUND
  Degeneration and altered mechanics of the facet joint can result in pathological nerve root compression and pain. Although lumbar facet joint space thinning has been reported in the context of low back pain, few studies have quantified the cervical facet joint space, especially in the context of pain.
  
  
  METHODS
  The cervical spine of 8 symptomatic and 10 asymptomatic subjects was imaged in the sagittal plane in a 3T magnetic resonance scanner, using a T2-pulse sequence optimized for bone imaging. The facet joint space was identified and segmented in the acquired images. The thickness and volume of the facet joint space, and their changes between positions, were computed from the 3-dimensional representation for all cervical levels on both sides.
  
  
  RESULTS
  Generally, the facet joint space thickness and volume were smaller in the symptomatic subjects than in the asymptomatic subjects. The differences were more robust on the left, especially in neutral and left torsion. The changes in both volume and thickness from neutral to torsion were also different in sign and magnitude at isolated joint levels between the 2 populations.
  
  
  CONCLUSIONS
  Quantification of the facet joint space architecture in the cervical spine of patients with radiculopathy is feasible using standard magnetic resonance imaging sequences. Measurements of the facet space thickness and volume, and their changes, from both pain-free and painful positions, can provide context for localizing potential sources of painful tissue loading.
  
  
  METHODS
  3.
authors.affiliation: *Departments of Neurosurgery †Bioengineering, and ‡Medical Image Processing Group, Department of Radiology, University of Pennsylvania, Philadelphia.
authors.forename: Nicolas V
authors.initials: NV
authors.lastname: Jaumard
authors.forename: Jayaram K
authors.initials: JK
authors.lastname: Udupa
authors.forename: William C
authors.initials: WC
authors.lastname: Welch
authors.forename: Beth A
authors.initials: BA
authors.lastname: Winkelstein
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000473:pathology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D010147:Pain Measurement; D056888:Patient Positioning; D011237:Predictive Value of Tests; D011843:Radiculopathy / Q000150:complications / Q000473:pathology* / Q000503:physiopathology*; D016059:Range of Motion, Articular; D054159:Torsion, Mechanical; D021801:Zygapophyseal Joint / Q000473:pathology* / Q000503:physiopathology*