Dalbayrak Sedat, Yaman Onur, Firidin Mustafa Nevzat, Yilmaz Tevfik, Yilmaz Mesut
Neurospinal Academy, Department of Neurosurgery, Istanbul, Turkey.
Turk Neurosurg. 2015;25(1):36-42. doi: 10.5137/1019-5149.JTN.9082-13.1.
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.
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.
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.
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.
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。
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。
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%。
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。
