Fatty Infiltration in the Cervical Extensor Muscles in Persistent Whiplash-Associated Disorders

Elliott, James M.; Jull, Gwendolen; Noteboom, J. Timothy; Darnell, Ross; Galloway, Graham J.; Gibbon, Wayne

doi:10.1097/01.brs.0000240841.07050.34

Cited by 251 publications

(285 citation statements)

References 54 publications

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“…First, we measured muscle volumes only on T2-weighted axial images because only T2-weighted pulse sequences were used for axial images in the protocol of the previous study. Previous reports have investigated the cervical musculature using T1-weighted [7][8][9]15] or T2-weighted [3,6,28] images. However, it remains controversial which is better for the evaluation of cervical musculature.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, this is the first longitudinal study on agerelated changes in the posterior extensor muscles of the cervical spine in healthy individuals. Recently, more attention has been focused on the posterior extensor muscles of the cervical spine with regard to minimally invasive cervical spinal surgery [19, 29-31, 33, 34] and patients with cervical spinal trauma, such as whiplash injury [7,9,14,18]. The age-related changes in the posterior extensor muscles described in this study can serve as a control for the assessment of changes in the posterior extensor muscles associated with various cervical spinal disorders and with non-surgical and surgical treatments for these disorders.…”

Section: Discussionmentioning

confidence: 99%

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Cross-sectional area of posterior extensor muscles of the cervical spine in asymptomatic subjects: a 10-year longitudinal magnetic resonance imaging study

et al. 2011

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There has been no prospective study on agerelated changes of the extensor muscles of the cervical spine in healthy subjects. This study was conducted to elucidate any association between the changes in cross-sectional area of the extensor muscles of the cervical spine on MRIs and cervical disc degeneration or the development of clinical symptoms. Sixty-two subjects who underwent MR imaging by a 1.5-Tesla machine between 1993 and 1996 as asymptomatic volunteers in a previous study were recruited again 10 years later for this follow-up study. The mean interval between the studies was 11.0 ± 0.7 years. The cross-sectional areas of the multifidus, semispinalis cervicis, semispinalis capitis, and splenius capitis at C3-C4, C4-C5, and C5-C6 intervertebral levels were measured on T2-weighted axial images using Image J 1.42. The mean cross-sectional areas of the deep extensor muscles were 1,396.8 ± 337.6 mm 2 at the C3-C4 level, 1,514.7 ± 381.0 mm 2 at the C4-C5 level, and 1,542.8 ± 373.5 mm 2 at the C5-C6 level in the previous investigation. The cross-sectional areas were 1,498.7 ± 374.4 mm 2 at the C3-C4 level, 1,569.9 ± 390.9 mm 2 at the C4-C5 level, and 1,599.6 ± 364.3 mm 2 at the 10-year follow-up. An increase in the cross-sectional area of the muscles was more frequently observed in subjects in their tens to thirties in the initial study, while a decrease was more frequently observed in those in their forties and older in the initial study. Disc degeneration was not correlated with a change in extensor muscle volume. Development of shoulder stiffness during follow-up was significantly negatively correlated with a change in the cross-sectional area of the deep extensor muscles.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cross-sectional area of posterior extensor muscles of the cervical spine in asymptomatic subjects: a 10-year longitudinal magnetic resonance imaging study

et al. 2011

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“…Recent MR studies have described the possible presence of visible changes to muscles and ligaments in neck pain patients after whiplash [9,36]. The reliability of quantitative methods [9,11] appears to be superior to that of qualitative methods [36].…”

Section: Discussionmentioning

confidence: 99%

The influence of age, anthropometrics and range of motion on the morphometry of the synovial folds of the lateral atlanto-axial joints: a pilot study

2010

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The purpose of this study was to investigate the effect of age, anthropometrics and cervical range of motion upon synovial fold volume. Ten healthy female subjects aged 20-40 years were included in the study. Age, height, body mass, dimensions of the head and neck and cervical range of motion of each subject were measured. Magnetic resonance (MR) images of the cervical spine were acquired; the volume of the ventral and dorsal synovial folds of the right and the left lateral atlanto-axial joints was measured using seed growing and thresholding methods. Using Spearman's correlation coefficient, it was determined that there was no correlation between synovial fold volume and age. Synovial fold volume was positively correlated with subject height and neck length but negatively correlated with body mass, body mass index and the circumference of the head and neck. The relationship between synovial fold volume and range of cervical motion varied with the plane of movement. The ability to image the synovial folds of the lateral atlanto-axial joints using MR imaging to determine their normal morphology provides the basis for investigating synovial fold pathology in patients with neck pain and headache.

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“…1 Degenerated muscle (for example, fatty infiltrates) has been observed, but the mechanisms are unclear. 2 Advanced imaging (for example, magnetic resonance spectroscopy (MRS) and diffusion-weighted imaging (DWI)) may assist in determining the mechanisms. Altered cord biochemistry has been observed in neurological disorders 3 and cervical myelopathy 4 using MRS, and increased water diffusion of denervated muscles is detailed with DWI.…”

Section: Introductionmentioning

confidence: 99%

Spinal cord metabolism and muscle water diffusion in whiplash

et al. 2011

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Study design: Case series. Objectives: To quantify spinal cord metabolites and neck muscle fast and slow water diffusion in a small sample of patients with chronic whiplash and healthy controls. Setting: Brisbane, Queensland, Australia. Methods: In five subjects with chronic whiplash and seven controls, we performed magnetic resonance spectroscopy (MRS) of the cervical spinal cord and diffusion-weighted imaging (DWI) of the cervical multifidus muscle. Results: Significant reductions in N-acetylaspartate/creatine ratios were found in subjects with chronic whiplash when compared with healthy controls (P ¼ 0.02). Significantly higher fast apparent diffusion coefficients (ADCs) were found in chronic whiplash when compared with the healthy controls (P ¼ 0.01). There was no difference in slow ADCs between the two groups (P ¼ 0.3). Conclusion: The potential value of MRS and DWI to quantify the presence of neuromuscular degeneration as a potential mechanism underlying chronic whiplash is recognized. Larger-scaled prospective studies are warranted and required.

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Fatty Infiltration in the Cervical Extensor Muscles in Persistent Whiplash-Associated Disorders

Cited by 251 publications

References 54 publications

Cross-sectional area of posterior extensor muscles of the cervical spine in asymptomatic subjects: a 10-year longitudinal magnetic resonance imaging study

Cross-sectional area of posterior extensor muscles of the cervical spine in asymptomatic subjects: a 10-year longitudinal magnetic resonance imaging study

The influence of age, anthropometrics and range of motion on the morphometry of the synovial folds of the lateral atlanto-axial joints: a pilot study

Spinal cord metabolism and muscle water diffusion in whiplash

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