Abstract
The authors determine the dynamic changes of the spinal canal during flexion and extension in patients with cervical spondylosis. Forty-six patients were studied inside a whole-body magnetic resonance (MR) scanner with between 50 degrees of flexion and 30 degrees of extension, using a positioning device. At neutral position (0 degree) and maximum flexion and extension sagittal T2-weighted turbo spin echo sequences were acquired. A significant (P < or = 0.05) increase of spinal stenosis was found at extension (48%, 22 of 46 patients) when compared with flexion (24%, 11 of 46). Cervical cord compression was diagnosed at flexion in 5 patients (11%) and at extension in 9 patients (20%). Concerning the number of patients with cervical cord compression at flexion and extension, significant differences (P < or = 0.05) were found in patients with degenerative changes at four segments compared with patients with one segment involvement. Magnetic resonance imaging identified a significant percentage of increased spinal stenosis at flexion and, especially, at extension, which was not observed at neutral position (0 degree). Flexion and extension MR imaging demonstrates additional information using a noninvasive technique concerning the dynamic factors in the pathogenesis of cervical spondylotic myelopathy.
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