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Liu A, Qiu NH, Zhong XR, Fang X, Liao JJ, Zhang ZP, Zheng PF, Hu YY, Hu KH, Xiong YH, Lu LJ, Xi XH, Wu Q, Bao YZ. Dynamic evaluation of the cervical spine by kinematic MRI in patients with cervical spinal cord injury without fracture and dislocation. J Orthop Surg Res 2023; 18:249. [PMID: 36973814 PMCID: PMC10044375 DOI: 10.1186/s13018-023-03745-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND The pattern of changes in the cervical spine and the spinal cord and their dynamic characteristics in patients with cervical spinal cord injury without fracture and dislocation remain unclear. This study aimed to evaluate the dynamic changes in the cervical spine and spinal cord from C2/3 to C7/T1 in different positions by using kinematic magnetic resonance imaging in patients with cervical spinal cord injury without fracture and dislocation. This study was approved by the ethics committee of Yuebei People's Hospital. METHODS Using median sagittal T2-weighted images for 16 patients with cervical spinal cord injury without fracture and dislocation who underwent cervical kinematic MRI, the anterior space available for the cord, spinal cord diameter, posterior space available for the cord from C2/3 to C7/T1, and Muhle's grade were determined. The spinal canal diameter was calculated by adding the anterior space available for the cord, spinal cord diameter, and posterior space available for the cord. RESULTS The anterior space available for the cord, posterior space available for the cord, and spinal canal diameters at C2/3 and C7/T1 were significantly higher than those from C3/4 to C6/7. Muhle's grades at C2/3 and C7/T1 were significantly lower than those at the other levels. Spinal canal diameter was lower in extension than in the neutral and flexion positions. In the operated segments, significantly lesser space was available for the cord (anterior space available for the cord + posterior space available for the cord), and the spinal cord diameter/spinal canal diameter ratio was higher than those in the C2/3, C7/T1, and non-operated segments. CONCLUSION Kinematic MRI demonstrated dynamic pathoanatomical changes, such as canal stenosis in different positions, in patients with cervical spinal cord injury without fracture and dislocation. The injured segment had a small canal diameter, high Muhle's grade, low space available for the cord, and high spinal cord diameter/spinal canal diameter ratio.
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Affiliation(s)
- Ao Liu
- Department of Spine Surgery, Yuebei People's Hospital, Guangdong Medical University, Shaoguan City, 512026, Guangdong, China
| | - Nan-Hai Qiu
- Department of Spine Surgery, Yuebei People's Hospital, Guangdong Medical University, Shaoguan City, 512026, Guangdong, China
| | - Xue-Ren Zhong
- Department of Spine Surgery, Yuebei People's Hospital, Guangdong Medical University, Shaoguan City, 512026, Guangdong, China
| | - Xiang Fang
- Department of Spine Surgery, Shaoguan First People's Hospital, Shaoguan City, 512026, Guangdong, China
| | - Jun-Jian Liao
- Department of Spine Surgery, Yuebei People's Hospital, Guangdong Medical University, Shaoguan City, 512026, Guangdong, China
| | - Zhi-Peng Zhang
- Department of Spine Surgery, Yuebei People's Hospital, Guangdong Medical University, Shaoguan City, 512026, Guangdong, China
| | - Pei-Feng Zheng
- Department of Spine Surgery, Yuebei People's Hospital, Guangdong Medical University, Shaoguan City, 512026, Guangdong, China
| | - Yong-Yu Hu
- Department of Spine Surgery, Yuebei People's Hospital, Guangdong Medical University, Shaoguan City, 512026, Guangdong, China
| | - Kong-He Hu
- Department of Spine Surgery, Yuebei People's Hospital, Guangdong Medical University, Shaoguan City, 512026, Guangdong, China
| | - Ying-Hui Xiong
- Department of Spine Surgery, Yuebei People's Hospital, Guangdong Medical University, Shaoguan City, 512026, Guangdong, China
| | - Lin-Jun Lu
- Department of Spine Surgery, Yuebei People's Hospital, Guangdong Medical University, Shaoguan City, 512026, Guangdong, China
| | - Xin-Hua Xi
- Department of Spine Surgery, Yuebei People's Hospital, Guangdong Medical University, Shaoguan City, 512026, Guangdong, China
| | - Qiang Wu
- Department of Spine Surgery, Shaoguan First People's Hospital, Shaoguan City, 512026, Guangdong, China
| | - Yong-Zheng Bao
- Department of Spine Surgery, Yuebei People's Hospital, Guangdong Medical University, Shaoguan City, 512026, Guangdong, China.
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Yip SWY, Griffith JF, Lee RKL, Liu KL. 4D CT to assess spinal instability in developmental anomaly of posterior arch of atlas. BJR Case Rep 2022; 8:20210038. [PMID: 36101739 PMCID: PMC9461738 DOI: 10.1259/bjrcr.20210038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 06/10/2021] [Accepted: 01/04/2022] [Indexed: 11/30/2022] Open
Abstract
Four-dimensional (4D) CT uniquely allows cinematic visualization of the entirety of joint motion throughout dynamic movement, which can reveal subtle or transient internal joint derangements not evident on static images. As developmental anomalies of the posterior arch can predispose to cervical spinal instability and neurological morbidity, precise assessment of spinal movement during motion is of clinical relevance. We describe the use of 4D-CT in a subject with partial absence of posterior C1 arch. This, to our knowledge, is the first such report. In at-risk individuals, 4D-CT has the potential to enable an assessment of spinal instability with a higher level of clarity and, in this sense, its more routine implementation may be a future direction.
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Affiliation(s)
- Stefanie WY Yip
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - James F Griffith
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Ryan KL Lee
- Department of Imaging and Interventional Radiology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
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Apparent Diffusion Coefficient of Diffusion-Weighted Imaging in Evaluation of Cervical Intervertebral Disc Degeneration: An Observational Study with 3.0 T Magnetic Resonance Imaging. BIOMED RESEARCH INTERNATIONAL 2018; 2018:6843053. [PMID: 29670903 PMCID: PMC5835286 DOI: 10.1155/2018/6843053] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 12/09/2017] [Accepted: 01/03/2018] [Indexed: 12/03/2022]
Abstract
Aims To investigate the correlation between the apparent diffusion coefficient (ADC) value and cervical intervertebral disc degeneration in adult symptomatic patients. Methods A total of 52 symptomatic and 40 healthy volunteers were included. DWI and routine MRI examinations were performed to their cervical spines. The cervical discs (from C2-C3 to C6-C7) were graded according to the Pfirrmann grading system, and ADC values of the nucleus pulposus (NP) were measured. Differences of the ADC values between different genders and anatomic levels were analyzed; the correlation between the ADC value and the Pfirrmann grade was investigated. The cut-off ADC values of each Pfirrmann grade were calculated. Results The mean ADC value of the NP decreased with increasing Pfirrmann grade (I–V) upon both patients and asymptotic volunteers. The ADC value decreased descendingly from C2-C3 to C5-C6 (P < 0.05) and then increased at C6-C7 (P < 0.05). Additionally, the comparison of the ADC values between different genders achieved statistical significance at each anatomical level (P < 0.05), except at C6-C7 (P > 0.05). Significant negative correlations between the ADC value and either age or Pfirrmann grade were observed. Conclusions Our preliminary findings suggest that the ADC value obtained by DWI can provide a reliable indicator to evaluate the cervical disc degeneration.
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Heller RS, Hwang SW, Riesenburger RI. Dorsal Cervical Spinal Cord Herniation Precipitated by Kyphosis Deformity Correction for Spinal Cord Tethering. World Neurosurg 2017; 100:709.e1-709.e4. [DOI: 10.1016/j.wneu.2017.02.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/31/2017] [Accepted: 02/02/2017] [Indexed: 11/25/2022]
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