Exacerbated pain in cervical radiculopathy at axial rotation, flexion, extension, and coupled motions of the cervical spine: evaluation by kinematic magnetic resonance imaging
| Autor: | Donald Resnick, D. Weinert, Lutz Bischoff, Martin Heller, Axel Falliner, Christoph Maier, Volker Lindner, Claus Muhle, Joong Mo Ahn |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Male Nerve root Posture Pain Kinematics Rotation Spinal Osteophytosis medicine Cervical spondylosis Humans Radiology Nuclear Medicine and imaging Displacement (orthopedic surgery) Observer Variation medicine.diagnostic_test business.industry Magnetic resonance imaging General Medicine Anatomy Middle Aged medicine.disease Magnetic Resonance Imaging Sagittal plane medicine.anatomical_structure Coronal plane Cervical Vertebrae Female business Intervertebral Disc Displacement |
| Zdroj: | Investigative radiology. 33(5) |
| ISSN: | 0020-9996 |
| Popis: | Rationale and objectives The authors evaluate the functional changes in patients with cervical radiculopathy and increasing symptoms after provocative maneuvers at flexion, extension, axial rotation, and coupled motions of the cervical spine. Methods Twenty-one patients with cervical disc herniation (n = 17) or cervical spondylosis (n = 4) in whom symptoms were elicited at flexion, extension, axial rotation, and coupled motions of the cervical spine were studied. The patients were examined inside a positioning device by using a circular surface coil for signal reception. At neutral position (0 degrees) and at provocative positions sagittal T2-weighted turbo spin-echo, axial T2-weighted two-dimensional flash sequence, sagittal three-dimensional (3D) fast imaging with steady state precision sequence and coronal 3D double-echo-in-the-steady-state sequences were obtained. The 3D sequences were reformatted in the axial and oblique coronal planes perpendicular to the exiting nerve roots. The images were evaluated for the size of disc herniations, the foraminal size and cervical cord rotation or displacement at provocative position compared with neutral position (0 degrees). Results Compared with neutral position (0 degrees), change in size of disc herniation was not found in any (0%) of the provocative positions. In five (24%) patients cervical cord rotation or displacement was noted at axial rotation. The foraminal size increased at flexion, axial rotation to the opposite side of pain and flexion combined with axial rotation to the opposite side of the pain. The foraminal size decreased at extension combined with axial rotation to the side of the pain. A decrease or no change in foraminal size was observed at either extension or axial rotation to the side of the pain. Conclusions In patients with cervical disc herniation or cervical spondylosis, exacerbated pain at defined provocative maneuvers is related more to changes in the foraminal size and to nerve root motion with, in some cases, cervical cord rotation or displacement than to changes in the size of herniated discs. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|