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Radiological and Clinical Significance of Cervical Dynamic Magnetic Resonance Imaging for Cervical Spondylotic Myelopathy

Authors :
Jun Jae Shin
Sun Joon Yoo
Tae Woo Kim
Jae-Young So
Won Joo Jeong
Mu Ha Lee
Joongkyum Shin
Yoon Ha
Source :
Neurospine, Vol 21, Iss 2, Pp 443-454 (2024)
Publication Year :
2024
Publisher :
Korean Spinal Neurosurgery Society, 2024.

Abstract

Objective The study compared the morphometric changes of the cervical spinal cord using dynamic magnetic resonance imaging (MRI) in patients with cervical spondylotic myelopathy (CSM) and assessed the correlation with kinematic changes, cord cross-sectional area (CSA), and high signal intensity (SI) on T2-weighted imaging (T2WI). Methods Patients with CSM were evaluated through dynamic MRI for sagittal and axial CSA changes of the cervical cord, cerebrospinal fluid (CSF) reserve ratio, degree of cord impingement, cord compression rate, range of motion (ROM), and severity of SI on T2WI. The degree of cord impingement was evaluated using the Muhle grading system. Clinical outcomes were assessed using Japanese Orthopaedic Association scoring and Nurick grade. Results The study included 191 patients (113 males) with a mean age of 55.34 ± 12.09 years. The lowest sagittal CSF reserve ratio and cord occupation rate were observed during extension. Cord impingement and SI change were more prevalent in extension-positioned MRI. There was no difference between ROM on dynamic radiographs and dynamic MRI. Preoperative cervical ROM was greater in patients with intensely high SI change. Conclusion Dynamic MRI is useful for evaluating neck movement. Patients with high SI had greater ROM before surgery but worse outcomes after. Neck extension exacerbated cervical stenosis and cord compression compared to flexion, and cervical spinal motion contributed to the severity of CSM. Cervical spinal motion should be carefully evaluated, particularly in hyperextension, to prevent worsening of CSM.

Details

Language :
English
ISSN :
25866583 and 25866591
Volume :
21
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Neurospine
Publication Type :
Academic Journal
Accession number :
edsdoj.44c6c664708ac712fbb9524d534
Document Type :
article
Full Text :
https://doi.org/10.14245/ns.2448166.083