Space Available for Cord, Motion, and disc degeneration at the adjacent segments level of degenerative cervical spondylolisthesis using kinematic MRI

Evaluation of kinematic changes of intervertebral discs and the space available for the cord

“…Improving knowledge concerning the average size and variability of the human spinal cord and SAC can be of importance when treating pathological conditions in the spinal cord. Further work is needed to reinforce the findings of Paholpak et al (1,12). In future analyses, it is important to include not only the anatomical factors, such as the amount of bulging and SAC, but the location of the bulging; lateral protrusions tend to produce radiculopathies while central disc protrusions are susceptible to producing symptomatic myelopathy.…”

“…This is a cross-sectional study of a limited number of patients that could not take into account the large intra-(up to 30%) and inter-individual variability (up to 13%) of both morphology and dimensions of the spinal cord. Moreover, significant differences related to age and postmortem state have also been identified (1,5,6,12). In particular, age appears to be a potential confounding factor, as spine segmental motion and flexibility tend to decrease with age.…”

“…Data on healthy human spinal cord morphometrics have been published for more than a century, using different measurement techniques and different anatomical landmarks. In recent years, there has been significant interest in the kinematic changes in disc bulging and the space available for the cord (SAC) in the cervical spine and the cauda equina in the lumbar spine (1)(2)(3)(4). However, the kinematic changes in intervertebral discs and the SAC within the thoracic region have not been well analyzed and, as a result, the amount of movement of the thoracic spinal cord within the dural sac is still unknown.…”

“…Compared to cervical or lumbar disc herniation, it is an uncommon condition, accounting for 1% to 2.9% of all symptomatic herniated discs. In cases of myelopathy with weakness in the legs, and bladder and bowel disfunction, thoracic disc herniation might be indicated for surgical treatment (1).…”

The clinical usefulness of preoperative imaging studies to select pathologic level in cervical spondylotic myelopathy: comparative analysis of three-position MRI and post-myelographic CT

“…After the recent introduction and validation of its usefulness (13,16,20,27), dynamic (flexion-extension or kinematic) MRI has gained in popularity worldwide. The pathophysiology of CSM is the result of synergic action of both static and dynamic factors and the dynamic factor and related volume change is important for the flexibility of the cervical spine in CSM.…”