Birnbaum Klaus, Maus Uwe, Tacke Josef
Orthopaedic Clinic Hennef, Adenauerplatz 1, 53773, Hennef, Germany.
Surg Radiol Anat. 2010 Feb;32(2):181-8. doi: 10.1007/s00276-009-0557-0. Epub 2009 Sep 18.
Frequently following a whiplash injury of the cervical spine, patients suffer from persistent pain symptoms. The MRI will in some of these cases show changes consistent with disk pathology or spinal stenosis, although in most instances the imaging studies will offer no adequate explanation for the described symptoms. The goal of our research was to develop and test a new MRI compatible device that will allow functional imaging of the cervical spine.
A total of 30 patients with whiplash injuries were evaluated during the first 6 weeks following trauma with the functional MRI. The examination was carried out with a T2-weighted turbo spin-echo sequence utilizing a new apparatus consisting of an inflatable air bag contained in a Plexiglas housing. Thanks to a valve placed outside of the examination room, it was possible to individually regulate the amount of air used to fill the pillow, thereby obtaining a full range of motion between flexion and extension.
In 25 cases no pathology was found during this examination. Two patients presented with scarring of the alar ligaments, indicative of a traumatic lesion. In two other instances the images in reclination revealed a bulging disk, while in one case a widening of the disk space was found as a sign for a rupture of the anterior longitudinal ligament.
Our study was able to demonstrate the applicability of the new functional testing device, which permits a standardized, continuous and dynamic evaluation of the cervical spine in a closed MRI.
颈椎挥鞭伤后，患者常常遭受持续性疼痛症状。在某些此类病例中，磁共振成像（MRI）会显示与椎间盘病变或椎管狭窄相符的变化，尽管在大多数情况下，影像学检查无法对所描述的症状给出充分解释。我们研究的目标是研发并测试一种新的与MRI兼容的设备，该设备将能够对颈椎进行功能成像。
共有30例挥鞭伤患者在创伤后的前6周内接受了功能MRI评估。检查采用T2加权快速自旋回波序列进行，并使用一种新装置，该装置由置于有机玻璃外壳内的可充气气囊组成。借助放置在检查室外的阀门，可以单独调节用于填充枕头的空气量，从而在屈伸之间获得全方位的运动。
在本次检查中，25例未发现病变。2例患者出现翼状韧带瘢痕形成，提示有创伤性损伤。另外2例患者在仰卧位时的图像显示椎间盘膨出，还有1例发现椎间盘间隙增宽，这是前纵韧带断裂的迹象。
我们的研究能够证明这种新型功能测试设备的适用性，它可以在封闭的MRI环境中对颈椎进行标准化、连续和动态的评估。
