Extension MRI is clinically useful in cervical myelopathy

Bartlett, R. J. V.; Rigby, Alan S.; Joseph, Jacob R.; Raman, Ashok; Kunnacherry, A.; Hill, Chapel

doi:10.1007/s00234-013-1208-z

Cited by 20 publications

(13 citation statements)

References 18 publications

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“…In previous work, the angle was measured as the difference in vertebrae angles at C2 and C7. 9,10 The angle between these 2 vertebrae is calculated by drawing a line parallel to the posterior edge of the vertebral body, which runs parallel to the spinal cord, and calculating the angle between those 2 lines. The far right artist's illustration depicts segmental rootlets and the formation of a spinal nerve root that emerges from the intervertebral foramen.…”

Section: Does Patient Positioning Within the Mr Imaging Environment Ementioning

confidence: 99%

Characterizing the Location of Spinal and Vertebral Levels in the Human Cervical Spinal Cord

Cadotte

Cohen‐Adad

et al. 2014

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Advanced MR imaging techniques are critical to understanding the pathophysiology of conditions involving the spinal cord. We provide a novel, quantitative solution to map vertebral and spinal cord levels accounting for anatomic variability within the human spinal cord. For the first time, we report a population distribution of the segmental anatomy of the cervical spinal cord that has direct implications for the interpretation of advanced imaging studies most often conducted across groups of subjects.

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Section: Does Patient Positioning Within the Mr Imaging Environment Ementioning

confidence: 99%

Characterizing the Location of Spinal and Vertebral Levels in the Human Cervical Spinal Cord

Cadotte

Cohen‐Adad

et al. 2014

AJNR Am J Neuroradiol

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“…Anatomical characteristics may influence biomechanics of the spine [12,26]. However, the Pavlov ratios and the SAC measurements did not reveal any distinct alterations in spinal canal diameter during cervical spine extension.…”

Section: Discussionmentioning

confidence: 78%

Kinetic DTI of the cervical spine: diffusivity changes in healthy subjects

et al. 2016

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“…Flexion-extension MRI techniques have been described in multiple studies (2–4) and it has been demonstrated that this technique may be helpful in the decision making for the surgical treatment of cervical spine myelopathy (22). Extension MRI in particular has been shown to be clinically useful in cervical myelopathy (3,4). These studies, however, involved the use of non-real-time flexion-extension MRI, aided by custom-built positioning sponges and other techniques that are difficult to reproduce and are therefore clinically impractical.…”

Section: Discussionmentioning

confidence: 99%

Real-time dynamic 3-T MRI assessment of spine kinematics: a feasibility study utilizing three different fast pulse sequences

et al. 2020

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Background Half-Fourier acquisition single-shot turbo spin-echo (HASTE), continuous radial gradient-echo (GRE), and True FISP allow real-time dynamic assessment of the spine. Purpose To evaluate the feasibility of adding dynamic sequences to routine spine magnetic resonance imaging (MRI) for assessment of spondylolisthesis. Material and Methods Retrospective review was performed of patients referred for dynamic MRI of the cervical or lumbar spine between January 2017 and 2018 who had flexion-extension radiographs within two months of MRI. Exclusion criteria were: incomplete imaging; spinal hardware; and inability to tolerate dynamic examination. Blinded, independent review by two board-certified musculoskeletal radiologists was performed to assess for spondylolisthesis (>3 mm translation); consensus review of dynamic radiographs served as the gold standard. Cervical spinal cord effacement was assessed. Inter-reader agreement and radiographic concordance was calculated for each sequence. Results Twenty-one patients were included (8 men, 13 women; mean age 47.9 ± 16.5 years). Five had MRI of the cervical spine and 16 had MRI of the lumbar spine. Mean acquisition time was 18.4 ± 1.7 min with dynamic sequences in the range of 58–77 s. HASTE and True FISP had the highest inter-reader reproducibility (κ = 0.88). Reproducibility was better for the lumbar spine (κ = 0.94) than the cervical spine (κ = 0.28). Sensitivity of sequences for spondylolisthesis was in the range of 68.8%–78.6%. All three sequences had high accuracy levels: ≥90.5% averaged across the cervical and lumbar spine. Cervical cord effacement was observed during dynamic MRI in two cases (100% agreement). Conclusion Real-time dynamic MRI sequences added to spine MRI protocols provide reliable and accurate assessment of cervical and lumbar spine spondylolisthesis during flexion and extension.

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Extension MRI is clinically useful in cervical myelopathy

Abstract: This is the first study to demonstrate added clinical value utilising extension MRI. In this cohort of difficult patients, when there was no T2 signal change in the cord, the presence of clinical myelopathy could only be predicted by utilising the data from extension imaging.

Cited by 20 publications

References 18 publications

Characterizing the Location of Spinal and Vertebral Levels in the Human Cervical Spinal Cord

Characterizing the Location of Spinal and Vertebral Levels in the Human Cervical Spinal Cord

Kinetic DTI of the cervical spine: diffusivity changes in healthy subjects

Real-time dynamic 3-T MRI assessment of spine kinematics: a feasibility study utilizing three different fast pulse sequences

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