Dynamic evaluation of cervical spinal cord by magnetic resonance imaging: Improvement of indication for surgical treatment of chronic cervical myelopathy

Koschorek, F.; Jensen, H.-P.; Terwey, B

doi:10.1016/0730-725x(86)90050-0

Cited by 10 publications

(3 citation statements)

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“…Although rheumatoid cervical arthritis is a common disease, a number of studies have addressed the problem of difficulty in its diagnosis [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16]. The first results on the use of MRI for the diagnosis of this disease were encouraging but were derived from rather small patient groups [1, 5-7, 12, 16].…”

Section: Discussionmentioning

confidence: 99%

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Magnetic resonance imaging of the craniocervical junction in rheumatoid arthritis: value, limitations, indications

Einig¹,

Higer²,

Meairs³

et al. 1990

Skeletal Radiol.

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The cervical spine is the second most common location for manifestation of rheumatoid arthritis (RA). Symptoms are typically related to involvement of the craniocervical junction. Unfortunately, conventional radiographic examination is often unable to demonstrate that RA is the cause of such symptoms. Magnetic resonance imaging (MRI) provides an unique opportunity to visualize nerves, connective tissue, and bone in all planes without the use of contrast agents. These features suggest that MRI could provide important information related to RA of the cervical spine. The possibilities and limitations of MRI were therefore evaluated in 60 patients with cervical RA. The main objective of this study was to correlate symptoms and clinical findings with MRI results to establish indications for this imaging procedure.

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Section: Discussionmentioning

confidence: 99%

“…Several authors recommend that subluxations should be examined with functional imaging using MRI [5,10,12]. It is questionable whether such an examination could not provoke a spinal cord compression, for the head is not freely hanging as in conventional functional radiography but is rather supported by body weight.…”

Section: Value and Limitations Of Mrimentioning

confidence: 99%

Magnetic resonance imaging of the craniocervical junction in rheumatoid arthritis: value, limitations, indications

Einig¹,

Higer²,

Meairs³

et al. 1990

Skeletal Radiol.

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“…In 1986, cervical kinematic MRI (KMRI) was first used by Koschorek [ 13 ] to evaluate the changes in the diameters and lengths of the cervical spinal canal and spinal cord. It was found that adverse mechanical tension might occur in the cervical spinal cord during flexion for the cervical spinal canal and spinal cord lengthen 12.0 mm in average compared with the spinal canal lengthen 28.0 mm in average from flexion to extension position.…”

Section: Introductionmentioning

confidence: 99%

Dynamic evaluation of the cervical spine by kinematic MRI in patients with cervical spinal cord injury without fracture and dislocation

et al. 2023

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Background The pattern of changes in the cervical spine and the spinal cord and their dynamic characteristics in patients with cervical spinal cord injury without fracture and dislocation remain unclear. This study aimed to evaluate the dynamic changes in the cervical spine and spinal cord from C2/3 to C7/T1 in different positions by using kinematic magnetic resonance imaging in patients with cervical spinal cord injury without fracture and dislocation. This study was approved by the ethics committee of Yuebei People's Hospital. Methods Using median sagittal T2-weighted images for 16 patients with cervical spinal cord injury without fracture and dislocation who underwent cervical kinematic MRI, the anterior space available for the cord, spinal cord diameter, posterior space available for the cord from C2/3 to C7/T1, and Muhle’s grade were determined. The spinal canal diameter was calculated by adding the anterior space available for the cord, spinal cord diameter, and posterior space available for the cord. Results The anterior space available for the cord, posterior space available for the cord, and spinal canal diameters at C2/3 and C7/T1 were significantly higher than those from C3/4 to C6/7. Muhle’s grades at C2/3 and C7/T1 were significantly lower than those at the other levels. Spinal canal diameter was lower in extension than in the neutral and flexion positions. In the operated segments, significantly lesser space was available for the cord (anterior space available for the cord + posterior space available for the cord), and the spinal cord diameter/spinal canal diameter ratio was higher than those in the C2/3, C7/T1, and non-operated segments. Conclusion Kinematic MRI demonstrated dynamic pathoanatomical changes, such as canal stenosis in different positions, in patients with cervical spinal cord injury without fracture and dislocation. The injured segment had a small canal diameter, high Muhle’s grade, low space available for the cord, and high spinal cord diameter/spinal canal diameter ratio.

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Morphological changes of the lower cervical spinal cord under neutral and fully flexed position by MRI in Chinese patients with Hirayama's disease

Pei

Zhang

et al. 2008

Amyotrophic Lateral Sclerosis

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We examined MR images of the spinal cord from the neutral neck to the fully flexed neck position in Chinese patients with Hirayama's disease (HD). MRI was performed on 25 HD patients and 31 healthy controls in the neutral and fully flexed neck positions. The mean anterior-posterior diameter (APD) and transverse diameter (TD) of the cervical cord at C6 level in the different positions was measured. Localized lower cervical cord atrophy and asymmetric cord flattening in a neutral neck position were highly suggestive of HD. The mean APDs were 5.6+/-0.7 mm in HD patients and 6.7+/-0.5 mm in controls (p <0.001). These changes seemed related to longer disease duration, i.e. >18 months. Although displacement forward of the lower cervical spinal cord without significant compression was observed in healthy young people, anterior shifting of posterior dural sac and lower cervical cord compression in flexion were distinctive and pathognomonic features of HD. The mean APDs were 4.3+/-0.9 mm in HD patients and 6.0+/-0.5 mm in controls in flexion (p <0.001). Our results may be helpful in diagnosing and assessing this disease.

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Dynamic evaluation of cervical spinal cord by magnetic resonance imaging: Improvement of indication for surgical treatment of chronic cervical myelopathy

Cited by 10 publications

References 1 publication

Magnetic resonance imaging of the craniocervical junction in rheumatoid arthritis: value, limitations, indications

Magnetic resonance imaging of the craniocervical junction in rheumatoid arthritis: value, limitations, indications

Dynamic evaluation of the cervical spine by kinematic MRI in patients with cervical spinal cord injury without fracture and dislocation

Morphological changes of the lower cervical spinal cord under neutral and fully flexed position by MRI in Chinese patients with Hirayama's disease

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