The Clinical Study Of Three-Dimensional Kinematic Magnetic Resonance Imaging In Diagnosis Of Cervical Spondylosis Radiculopathy

Objective: To determine the dynamic functional changes of neuroforaminal size that occur during flexion-extension of the cervical spine in healthy persons and Cervical Spondylosis Radiculopathy patients using kinematic magnetic resonance imaging, To study the clinical value of Three-Dimensional MRI and to obtain early precise diagnosis of Cervical Spondylosis Radiculopathy.Methods: The cervical spines of 32 healthy persons and 30 Cervical Spondylosis Radiculopathy patients were examined in a whole-body magnetic resonance scanner at three position: flexion position,neutral position and extension position. The images were analyzed with respect to the neuroforaminal size at each position using a reformatted 3D-SPGR sequence.Results: All of the images were fairly good in the healthy volunteers. The neural foramen is smooth and regular. At flexion position, widening of the neuroforaminal size up to 20%(compared with neutral position) was observed. Conversely, at extension a decrease in the size of the neural foramen up to 20% was recognized. Statistically significant differences (P<0.05) were found in the neuroforaminal size between different positions. The images of the Cervical Spondylosis Radiculopathy patients reveal the near tendency, which is 14% decrease from neutral to extension position. With regard to the distribution of the neural foramen shape, we found that the thin shaped foramen is the least but focus on C4-7 level. This trend became more obvious with the position changed from neural to extension.Conclusion: The Three-Dimensional Magnetic Resonance Imaging with kinematic-scan method can obtain complete detailed information about the cervical spine concerning the physiological changes of the neural foramen during flexion-extension. The most important reasons of neural foramen stenosis are osteophytes around the uncovertebral joints,hypermobile instability and disk herniation. When extension, the decrease of transverse dimension is more obvious than decrease of vertical dimension. The 3D-Kinematic MRI can detect fluctuating intervertebral disc herniation, hypermobile spinal instability and others conditions that cannot be discovered in routine examination Using 3D-Kinematic MRI Precise diagnosis of the Cervical Spondylosis Radiculopathy can be obtained earlier than routine examination.