MR imaging of the cervical spine: neurovascular anatomy

Flannigan, BD; Lufkin, R B; McGlade, Charles T.; Winter, James; Batzdorf, Ulrich; Wilson, G H; Rauschning, Wolfgang; Wg, Bradley

doi:10.2214/ajr.148.4.785

Cited by 49 publications

(24 citation statements)

References 7 publications

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“…Neural foraminal stenosis in the cervical spine can be visualized with MRI, [11][12][13]21,22 but false-positive and -negative rates tend to be high in clinical settings. A single set of images with the patient in the supine position may not accurately represent the severity of foraminal stenosis because the foraminal dimensions change as the patient's posture changes.…”

Section: Discussionmentioning

confidence: 99%

Morphologic Changes in the Cervical Neural Foramen due to Flexion and Extension

Kitagawa

Fujiwara

Kobayashi

et al. 2004

Spine

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Section: Discussionmentioning

confidence: 99%

Morphologic Changes in the Cervical Neural Foramen due to Flexion and Extension

Kitagawa

Fujiwara

Kobayashi

et al. 2004

Spine

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“…4,9,11,14 The vertical diameter of the foramen has been reported to be approximately twice that of the anteroposterior diameter, and the foramen encompasses the spinal nerves, fatty tissues, and small veins. 4,11,23,30 While the cervical anatomy and the relationship between the contents of the neural foramina have been documented through numerous published studies, 3,8,9,10 our review of the literature found no normative data establishing the dimensions of the cervical intervertebral foramen in vivo, nor how these dimensions are altered with various changes in the position of the head or neck.…”

mentioning

confidence: 76%

Dimensions of the Cervical Neural Foramina in Resting and Retracted Positions Using Magnetic Resonance Imaging

Lentell¹,

Kruse²,

Chock³

et al. 2002

J Orthop Sports Phys Ther

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Study Design: Prospective within-subject experimental design using a sample of convenience. Objectives: To describe cervical foraminal dimensions in vivo of nonimpaired, asymptomatic individuals in a neutral cervical spine position using magnetic resonance images, and then to document dimensional changes of the foramina when placing the neck in a retracted position. Background: Physical therapists frequently use movement interventions to treat spine dysfunction. The influence of positional changes of the head and neck on the dimensions of the cervical neural foramina is not well documented. Methods and Measures: Twenty asymptomatic subjects (10 men and 10 women), 22 to 25 years of age (mean ± SD = 23.7 ± 0.8), underwent magnetic resonance imaging of the cervical spine in both neutral and retracted positions. Bilateral measurements were documented in both positions and compared for height, width, and area of each subject's intervertebral foramen from C2-C3 to C7-T1. Results: No significant differences (P Ͼ 0.004) were found between the 2 neck positions. With the single exception of foraminal area at C3-C4, the mean values of height, width, and area in the retracted position were equal to or larger than those of the cervical neutral position. Conclusions: Therapeutic maneuvers using retraction of the cervical spine do not promote positional stenosis of the intervertebral foramen in the healthy neck.

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“…Superior articular process, the ligamentum flavum, and the fibrous tissue surrounding the radix usually outcrops nerve root compression posteriorly [6]. With MR images, each foramen is outlined by a dark line corresponding to the compact cortical bone of the inferior pedicle cortex superiorly, the superior pedicle cortex inferiorly, the posterior cortical bone of the vertebral bodies anteriorly, and the cortical bone of the posterior elements posteriorly [7]. The exact anatomic struc- tures that affect the nerve root may vary for each individual.…”

Section: Discussionmentioning

confidence: 99%

“…Oblique MR views can be employed when routine axial and sagittal images fail to clarify the situation [11]. Therefore, electronically activated oblique plane imaging was used to show the nerve roots 'en face' in their respective neural foramina [7]. Despite a successful surgical decompression, osteophytes have the propensity to regenerate in time.…”

Section: Discussionmentioning

confidence: 99%

Oblique MR Imaging in Cervical Spine Surgery

Şimşek¹

2015

Ann Clin Anal Med

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ÖzetBu çalışmanın amacı, 45 derece oblik açıda çekilmiş manyetik rezonans (MR) gö-rüntülemenin karmaşık servikal patolojilerde ve ameliyat sonrası değerlendirme-deki faydasını vurgulamaktır. 2002 ve 2007 yılları arasında dejeneratif servikal omurga bozukluklarından dolayı 252 hastaya cerrahi müdahalede bulunduk. Bunların takiplerinde bazı hastalar devam eden kök ağrısından dolayı servikal spinal MR ile değerlendirildiler. Burada, servikal oblik MRın etkinliğini ortaya koymak için dört vaka takdim edilecektir. İlk vaka, ameliyat öncesi dönemde de cerrahi kararında oblik MR görüntülerinin önemini vurgulamaktadır. İkinci vakada, oblik gö-rüntülere dayanarak reoperasyona karar verilmiştir. Üçüncü vaka implantların neden olduğu artefaktlara, ve bu durumda 45 derece oblik MR görüntülerinin faydasına dikkati çekmektedir. Dördüncü olguda, servikal implanta rağmen oblik kesitlerde foramenlerin sağlıklı değerlendirilebildiği görülmektedir. Ameliyat sonrası dönemde, alışılmış MR görüntülerinde herhangi bir patolojiye atfedilemeyen devam eden kök ağrısı olan servikal implantlı hastalar, oblik servikal MR'dan fayda sağlayabilirler. case emphasizes its importance also in decision of treatment in the preoperative period. In the second case, reoperation was decided regarding oblique MR images. Third case draws attention to the artifacts due to implants and efficacy of 45° oblique MR images in such circumstances. In the fourth case despite the implants, foramina could be visualized clearly in oblique cuts. Patients with postoperative radiculopathy with implants that could not be ascribed to any pathology visible in the conventional MR sequences might benefit from oblique MR imaging. In this study, it has been aimed to depict the efficacy of 45° oblique MR images in selected patients for delineating foraminal pathology via sample cases particularly in the postoperative period. Anahtar Kelimeler Keywords

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MR imaging of the cervical spine: neurovascular anatomy

Cited by 49 publications

References 7 publications

Morphologic Changes in the Cervical Neural Foramen due to Flexion and Extension

Morphologic Changes in the Cervical Neural Foramen due to Flexion and Extension

Dimensions of the Cervical Neural Foramina in Resting and Retracted Positions Using Magnetic Resonance Imaging

Oblique MR Imaging in Cervical Spine Surgery

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