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颈椎动态磁共振成像在脊髓型颈椎病手术治疗中的作用

The contribution of cervical dynamic magnetic resonance imaging to the surgical treatment of cervical spondylotic myelopathy.

作者信息

Dalbayrak Sedat, Yaman Onur, Firidin Mustafa Nevzat, Yilmaz Tevfik, Yilmaz Mesut

机构信息

Neurospinal Academy, Department of Neurosurgery, Istanbul, Turkey.

出版信息

Turk Neurosurg. 2015;25(1):36-42. doi: 10.5137/1019-5149.JTN.9082-13.1.


DOI:10.5137/1019-5149.JTN.9082-13.1
PMID:25640543
Abstract

AIM: Cervical spine is the most kinetic segment of the whole vertebrae. The radiologic imaging methods concern with the morphologic changes but give no functional data. At flexion, spinal cord strains, anterior osteophytic compression increases. At extension, spinal canal gets narrower, cord shortens and gets thicker, compression of posterior ligament gets abberant and cord compression increases. MATERIAL AND METHODS: 258 cervical spondylotic myelopathy (CSM) cases were scanned by conventional magnetic resonance imaging (MRI) and additionally dynamic MRI. Contributions of dynamic cervical MRI to the surgical plans and results were evaluated. RESULTS: We had sagittal and axial T2W MR scans at flexion and extension, in addition to the neutral cervical MR imaging. We found that the AP diameter of spinal canal is increased 14.9 % in flexion and decreased 13.4 % in extension relative to the neutral MR imaging. CONCLUSION: The changes of the cord compression and the transvers area of cord which is the most important prognostic indicator in spinal diseases and also the area of spinal cord and subarachnoid space can be detected via dynamic axial sections of MRI. Dynamic MR images may be helpfull in the decision making for the surgical treatment of CSM.

摘要

目的:颈椎是整个脊椎中活动最频繁的节段。放射影像学方法关注形态学变化,但无法提供功能数据。颈椎前屈时,脊髓受到牵拉,前方骨赘压迫增加。颈椎后伸时,椎管变窄,脊髓缩短变厚,后纵韧带受压异常,脊髓压迫增加。 材料与方法:对258例脊髓型颈椎病(CSM)患者进行常规磁共振成像(MRI)扫描,并额外进行动态MRI扫描。评估动态颈椎MRI对手术方案及结果的影响。 结果:除了颈椎中立位MR成像外,我们还获得了颈椎前屈和后伸时的矢状位和轴位T2加权MR扫描图像。我们发现,相对于颈椎中立位MR成像,椎管前后径在颈椎前屈时增加14.9%,在颈椎后伸时减小13.4%。 结论:通过MRI的动态轴位图像可以检测到脊髓压迫的变化以及脊髓横截面积的变化,脊髓横截面积是脊柱疾病中最重要的预后指标,也是脊髓和蛛网膜下腔的面积。动态MR图像可能有助于脊髓型颈椎病手术治疗的决策。

相似文献

[1]
The contribution of cervical dynamic magnetic resonance imaging to the surgical treatment of cervical spondylotic myelopathy.

Turk Neurosurg. 2015

[2]
Dynamic evaluation of the spinal cord in patients with cervical spondylotic myelopathy using a kinematic magnetic resonance imaging technique.

J Spinal Disord Tech. 2009-2

[3]
Preoperative evaluation of the cervical spondylotic myelopathy with flexion-extension magnetic resonance imaging: about a prospective study of fifty patients.

Spine (Phila Pa 1976). 2011-8-1

[4]
[Influence of Cervical Spondylotic Spinal Cord Compression on Cerebral Cortical Adaptation. Radiological Study].

Acta Chir Orthop Traumatol Cech. 2015

[5]
Cervical extension magnetic resonance imaging in evaluating cervical spondylotic myelopathy.

Acta Neurochir (Wien). 2014-2

[6]
Clinical and magnetic resonance imaging predictors of the surgical outcomes of patients with cervical spondylotic myelopathy.

Clin Neurol Neurosurg. 2018-11

[7]
The value of dynamic MRI in the treatment of cervical spondylotic myelopathy: a protocol for a prospective randomized clinical trial.

BMC Musculoskelet Disord. 2020-2-7

[8]
Magnetic resonance T2 image signal intensity ratio and clinical manifestation predict prognosis after surgical intervention for cervical spondylotic myelopathy.

Spine (Phila Pa 1976). 2010-5-1

[9]
[Effects of spinal cord decompression in patients with cervical spondylotic myelopathy oncortical brain activations].

Rozhl Chir. 2014-11

[10]
Skip laminectomy and laminoplasty for cervical spondylotic myelopathy: a prospective study of clinical and radiologic outcomes.

J Spinal Disord Tech. 2010-4

引用本文的文献

[1]
The Value of Dynamic MRI in Cervical Radiculopathy: A Report of Two Cases.

Cureus. 2025-5-1

[2]
T2-weighted MRI high signal in cervical spondylotic myelopathy is associated with dynamic change.

J Orthop Surg Res. 2025-4-9

[3]
Radiological and Clinical Significance of Cervical Dynamic Magnetic Resonance Imaging for Cervical Spondylotic Myelopathy.

Neurospine. 2024-6

[4]
Utility of a 2D kinematic HASTE sequence in magnetic resonance imaging assessment of adjacent segment degeneration following anterior cervical discectomy and fusion.

Eur Radiol. 2024-2

[5]
The value of dynamic MRI in cervical spondylotic myelopathy: About 24 cases.

Ann Med Surg (Lond). 2022-9-22

[6]
Ligamentum Flavum Buckling vs Hypertrophy in Cervical Myelopathy Using Dynamic Imaging: Are Instability and Loss of Disc Height the Culprits?

Int J Spine Surg. 2022-4

[7]
Degenerative Cervical Myelopathy: Insights into Its Pathobiology and Molecular Mechanisms.

J Clin Med. 2021-3-15

[8]
The Assessment of Dynamic Spinal Cord Impingement by Kinematic Magnetic Resonance Imaging in Patients with Traumatic Central Cord Syndrome.

Ther Clin Risk Manag. 2021-1-7

[9]
Feasibility and Safety of Cervical Kinematic Magnetic Resonance Imaging in Patients with Cervical Spinal Cord Injury without Fracture and Dislocation.

Orthop Surg. 2020-4

[10]
The value of dynamic MRI in the treatment of cervical spondylotic myelopathy: a protocol for a prospective randomized clinical trial.

BMC Musculoskelet Disord. 2020-2-7

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