Magnetic Resonance Imaging Assessment of Craniovertebral Ligaments and Membranes After Whiplash Trauma

Kråkenes, Jostein; Kaale, Bertel Rune

doi:10.1097/01.brs.0000245871.15696.1f

Cited by 100 publications

(75 citation statements)

References 45 publications

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“…In addition, Shafaie et al [29] reported that the correlation between MRI and surgical findings was frequently unreliable. Recording the standard MRI in supine position, leakage of chemical mediators or inflammatory cytokines through annular tear, functional instability, fluctuating disc bulges, and restrictions caused by discoligament injuries are some of the explanations proposed for this weak agreement [28][29][30][31][32][33]. Furthermore, duration of symptoms could be a causative factor as Jensen et al [34] indicated that improvement of disc herniations and nerve root compromise over time did not coincide with definite recovery.…”

Section: Discussionmentioning

confidence: 99%

A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

2014

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Purpose The aim of this study was to evaluate the agreement of magnetic resonance imaging and electrodiagnostic studies by comparing their findings in patients with clinically suspected radiculopathy. The agreements between these two procedures and clinical findings were also examined. Methods In a 2-year cross-sectional study, a total of 114 patients with clinically suspected cervical or lumbosacral radiculopathy were included. Results The total agreements between clinical with MRI and EDX findings were 72 and 52 %, respectively while their agreements were similar in group definite (89 vs. 82 %). The agreement between EDX and MRI was 59.6 in total and 49 % with respect to clinical findings. Conclusion This study further supports that these two methods are complementary in general. It is reasonable to add EDX when there is discrepancy between MRI and clinical findings or when MRI neurologic findings are not visible.

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Section: Discussionmentioning

confidence: 99%

A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

2014

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“…[4][5][6] Nevertheless, the involvement of the alar ligaments in WAD has not been conclusively established in prior imaging and postmortem studies. 7 Imaging studies showed that the upper cervical ligaments can be evaluated by using MR imaging, [8][9][10] especially proton-weighted sequences. MR imaging studies analyzing alar ligaments have included not only noninjured individuals [9][10][11][12][13][14][15] but also selected patients with WAD.…”

mentioning

confidence: 99%

“…MR imaging studies analyzing alar ligaments have included not only noninjured individuals [9][10][11][12][13][14][15] but also selected patients with WAD. 8,11 "WAD" is defined as an injury caused by hyperextension and subsequent hyperflexion of the cervical spine associated with sudden acceleration and/or deceleration of the head, most often caused by a car crash. 16 Whiplash injury of the cervical spine is a frequent issue requiring medical expertise.…”

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confidence: 99%

Variability of Morphology and Signal Intensity of Alar Ligaments in Healthy Volunteers Using MR Imaging

Lummel¹,

Zeif²,

Kloetzer³

et al. 2010

AJNR Am J Neuroradiol

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“…These structures could be well visualized by magnetic resonance imaging (MRI) [17][18][19]. In recent years, with the development of more detailed MRI techniques morphologic changes of the ligaments and membranes in the craniocervical junction, especially alar and transverse ligaments have been discussed [18,[20][21][22][23][24][25][26][27]. However, most of these studies include relatively small samples of patients and thus their results were inconsistent and lacked statistical strength.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging signal changes of alar and transverse ligaments not correlated with whiplash-associated disorders

Shen

2012

Eur Spine J

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Purpose Hypothesis that loss of integrity of the membranes in the craniocervical junction might be the cause of neck pain in patients with whiplash-associated disorders (WADs) has been proposed. In recent years, with development of more detailed magnetic resonance imaging (MRI) techniques, morphologic changes of the ligaments and membranes in the craniocervical junction, especially alar and transverse ligaments have been discussed. A metaanalysis was performed to evaluate the relationship of MRI signal changes of alar and transverse ligaments and WADs. Methods A systematic search of EMBASE, PUBMED, and Cochrane Library and references from eligible articles were conducted. Comparative studies reporting on evaluating the relationship between MRI high-signal changes of alar and transverse ligaments and WADs were regarded eligible. A pooled estimate of effect size was produced. Results Alar ligaments: Six studies (total n = 622) were included. MRI signal changes of alar ligaments did not appear to be related with WADs (P = 0.20, OR = 1.54, 95 % CI = 0.80-2.94). Heterogeneity was present (I 2 = 46 %, P = 0.10), which was eliminated upon sensitivity analysis bringing the OR to 1.27 (95 % CI = 0.87-1.86, I 2 = 0 %). Transverse ligaments: Four studies (total n = 489) were included. MRI signal changes of transverse ligament did not appear to be related with WADs (P = 0.51, OR = 1.44, 95 % CI = 0.49-4.21). Heterogeneity was present (I 2 = 77 %, P = 0.005), which was eliminated upon sensitivity analysis bringing the OR to 0.79 (95 % CI = 0.49-1.28, I 2 = 0 %). Conclusion MRI signal changes of alar and transverse ligaments are not supposed to be caused by whiplash injury, and MRI examination of alar and transverse ligaments should not be used as the routine workup of patients with WADs.

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Magnetic Resonance Imaging Assessment of Craniovertebral Ligaments and Membranes After Whiplash Trauma

Abstract: Whiplash trauma can damage soft tissue structures of the upper cervical spine, particularly the alar ligaments. Structural lesions in this area contribute to the understanding of the chronic whiplash syndrome.

Cited by 100 publications

References 45 publications

A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

A comparison of magnetic resonance imaging with electrodiagnostic findings in the evaluation of clinical radiculopathy: a cross-sectional study

Variability of Morphology and Signal Intensity of Alar Ligaments in Healthy Volunteers Using MR Imaging

Magnetic resonance imaging signal changes of alar and transverse ligaments not correlated with whiplash-associated disorders

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