Functional MR imaging of the cervical spine in patients with rheumatoid arthritis

1998 ◽  
Vol 39 (5) ◽  
pp. 543-546 ◽  
Author(s):  
K.-H. Allmann ◽  
M. Uhl ◽  
P. Uhrmeister ◽  
K. Neumann ◽  
J. von Kempis ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cervical Spine ◽  
Mr Imaging ◽  
Cord Compression ◽  
Foramen Magnum ◽  
Neutral Position ◽  
Additional Information ◽  
Functional Mr Imaging ◽  
Flexion And Extension ◽  
Mr Study

Purpose: to evaluate functional MR imaging in patients with rheumatoid arthritis (RA) involving the cervical spine Material and Methods: We used a device that allows MR examination to be made of the cervical spine in infinitely variable degrees of flexion and extension. Dynamic functional MR imaging was performed on 25 patients with RA Results: Functional MR imaging was able to show the degree of vertebral instability of the occipito-atlantal or atlanto-axial level as well as the subaxial level. by performing functional MR imaging, we were able to demonstrate the extent of synovial tissue around the dens, and the impingement and displacement of the spinal cord during flexion and extension. the basilar impression, the cord impingement into the foramen magnum, the cord compression, the slipping of vertebrae, and the angulation of the cord were all much more evident in functional than in static MR imaging Conclusion: Functional MR imaging provided additional information in patients with RA, and is valuable in patients who have a normal MR study in the neutral position and yet have signs of a neurological deficit. Functional MR imaging is important in the planning of stabilizing operations of the cervical spine

Functional MR imaging of the cervical spine in patients with rheumatoid arthritis

1998 ◽  
Vol 39 (5) ◽  
pp. 543-546 ◽  
Author(s):  
K. -H. Allmann ◽  
M. Uhl ◽  
P. Uhrmeister ◽  
K. Neumann ◽  
J. von Kempis ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cervical Spine ◽  
Mr Imaging ◽  
Functional Mr Imaging

scholarly journals Rheumatoid Arthritis Affecting the Upper Cervical Spine: Biomechanical Assessment of the Stabilizing Ligaments

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Carolin Meyer ◽  
Jan Bredow ◽  
Elisa Heising ◽  
Peer Eysel ◽  
Lars Peter Müller ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cervical Spine ◽  
Neurological Disorders ◽  
Cord Compression ◽  
Upper Cervical Spine ◽  
Neutral Position ◽  
Transverse Ligament ◽  
Alar Ligaments ◽  
Upper Cervical

Diameters of anterior and posterior atlantodental intervals (AADI and PADI) are diagnostically conclusive regarding ongoing neurological disorders in rheumatoid arthritis. MRI and X-ray are mostly used for patients’ follow-up. This investigation aimed at analyzing these intervals during motion of cervical spine, when transverse and alar ligaments are damaged. AADI and PADI of 10 native, human cervical spines were measured using lateral fluoroscopy, while the spines were assessed in neutral position first, in maximal inclination second, and in maximal extension at last. First, specimens were evaluated under intact conditions, followed by analysis after transverse and alar ligaments were destroyed. Damage of the transverse ligament leads to an increase of the AADI’s diameter about 0.65 mm in flexion and damage of alar ligaments results in significant enhancement of 3.59 mm at mean. In extension, the AADI rises 0.60 mm after the transverse ligament was cut and 0.90 mm when the alar ligaments are damaged. After all ligaments are destroyed, AADI assessed in extension closely resembles AADI at neutral position. Ligamentous damage showed an average significant decrease of the PADI of 1.37 mm in the first step and of 3.57 mm in the second step in flexion, while it is reduced about 1.61 mm and 0.41 mm in the extended and similarly in the neutrally positioned spine. Alar and transverse ligaments are both of obvious importance in order to prevent AAS and movement-related spinal cord compression. Functional imaging is necessary at follow-up in order to identify patients having an advanced risk of neurological disorders.

The use of flexion-extension magnetic resonance imaging for evaluating signal intensity changes of the cervical spinal cord

2009 ◽  
Vol 10 (4) ◽  
pp. 366-373 ◽  
Author(s):  
Kern H. Guppy ◽  
Mark Hawk ◽  
Indro Chakrabarti ◽  
Amit Banerjee
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Spinal Cord Compression ◽  
Cord Compression ◽  
Resonance Imaging ◽  
Flexion Extension ◽  
Dynamic Mr

The authors present 2 cases involving patients who presented with myelopathy. Magnetic resonance imaging of the cervical spine showed spinal cord signal changes on T2-weighted images without any spinal cord compression. Flexion-extension plain radiographs of the spine showed no instability. Dynamic MR imaging of the cervical spine, however, showed spinal cord compression on extension. Compression of the spinal cord was caused by dynamic anulus bulging and ligamentum flavum buckling. This report emphasizes the need for dynamic MR imaging of the cervical spine for evaluating spinal cord changes on neutral position MR imaging before further workup for other causes such as demyelinating disease.

Cervical laminectomy without fusion in patients with rheumatoid arthritis

1999 ◽  
Vol 90 (2) ◽  
pp. 186-190 ◽  
Author(s):  
Dan Christensson ◽  
Hans Säveland ◽  
Stefan Zygmunt ◽  
Kjell Jonsson ◽  
Urban Rydholm
Keyword(s):  
Rheumatoid Arthritis ◽  
Cervical Spine ◽  
Cord Compression ◽  
Spinal Instability ◽  
Decompressive Laminectomy ◽  
Content Type ◽  
Fusion Procedure ◽  
Cervical Laminectomy ◽  
Flexion Extension ◽  
Fine Print

Object. The authors performed a prospective study to determine whether cervical laminectomy without simultaneous fusion results in spinal instability. Methods. Because of clinical and radiographic signs of cord compression, 15 patients with rheumatoid arthritis (including one with Bechterew's disease) and severe involvement of the cervical spine underwent decompressive laminectomy without fusion performed on one or more levels. Preoperative flexion—extension radiographs demonstrated dislocation but no signs of instability at the level of cord compression. Clinical and radiological reexamination were performed twice at a median of 15 months (6–24 months) and 43 months (28–72 months) postoperatively. One patient developed severe vertical translocation 28 months after undergoing a C-1 laminectomy, which led to sudden tetraplegia. She required reoperation in which posterior fusion was performed. No signs of additional instability at the operated levels were found in the remaining 14 patients. In three patients increased but stable dislocation was demonstrated. The results of clinical examination were favorable in most patients, with improvement of neurological symptoms and less pain. Conclusions. The authors conclude that decompressive laminectomy in which the facet joints are preserved can be performed in the rheumatoid arthritis-affected cervical spine in selected patients in whom signs of cord compression are demonstrated, but in whom radiographic and preoperative signs of instability are not. Performing a simultaneous fusion procedure does not always appear necessary. Vertical translocation must be detected early, and if present, a C-1 laminectomy should be followed by occipitocervical fusion.

The cervical spine in rheumatoid arthritis: relationship between neurologic signs and morphology on MR imaging and radiographs

1996 ◽  
Vol 25 (2) ◽  
pp. 113-118 ◽  
Author(s):  
M. Reijnierse ◽  
Johan L. Bloem ◽  
Ben A. C. Dijkmans ◽  
Herman M. Kroon ◽  
Herma C. Holscher ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cervical Spine ◽  
Mr Imaging

Postlaminectomy cervical spinal cord compression demonstrated by dynamic magnetic resonance imaging

1998 ◽  
Vol 88 (1) ◽  
pp. 155-157 ◽  
Author(s):  
Tetsuya Morimoto ◽  
Hiroyuki Ohtsuka ◽  
Toshisuke Sakaki ◽  
Masahiko Kawaguchi
Keyword(s):  
Spinal Cord ◽  
Magnetic Resonance ◽  
Mr Imaging ◽  
Spinal Cord Compression ◽  
Cervical Myelopathy ◽  
Cervical Spinal Cord ◽  
Cord Compression ◽  
Neutral Position ◽  
Dynamic Magnetic Resonance ◽  
Canal Stenosis

✓ This 32-year-old man had undergone C3–7 laminectomy for posttraumatic cervical myelopathy associated with spinal canal stenosis. He developed recurrent myelopathy 5 years after the initial operation. Dynamic magnetic resonance (MR) imaging of the cervical spine demonstrated spinal cord compression with diffuse canal stenosis while the neck was in the extended position, whereas no significant stenosis was visualized in the neutral position. Sagittal and axial MR images of the affected levels demonstrated striking changes in the cervical spinal cord configuration. Because of an associated hard osteophyte formation and protruded disc, as well as a hypertrophied posterior longitudinal ligament, an anterior decompression and fusion with plate fixation were performed from C-4 to C-7. The postoperative course was uneventful, with subsequent neurological improvement. It is concluded that dynamic MR imaging aids the search for the cause of recurrent postlaminectomy cervical myelopathy after initial improvement following decompressive surgery.

scholarly journals DYNAMIC MAGNETIC RESONANCE IMAGING: PRELIMINARY PRESENTATION OF A TECHNIQUE

2016 ◽  
Vol 15 (3) ◽  
pp. 209-212
Author(s):  
BRUNO DA COSTA ANCHESCHI ◽  
ANIELLO SAVARESE ◽  
RAPHAEL DE REZENDE PRATALI ◽  
DANIEL AUGUSTO CARVALHO MARANHO ◽  
MARCELLO TEIXEIRA CASTILHA ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Cord ◽  
Cervical Spine ◽  
Magnetic Resonance ◽  
Cervical Spondylotic Myelopathy ◽  
Dynamic Magnetic Resonance Imaging ◽  
Neutral Position ◽  
Resonance Imaging ◽  
Significant Difference ◽  
Flexion And Extension

ABSTRACT Objective: To evaluate morphometric variations of the cervical spine in patients with cervical spondylotic myelopathy (CSM) using dynamic magnetic resonance imaging (MRI) in neutral, flexion and extension positions. Methods: This is a prospective study of patients with CSM secondary to degenerative disease of the cervical spine. The morphometric parameters were evaluated using T2-weighted MRI sequences in the sagittal plane in neutral, flexion and extension position of the neck. The parameters studied were the anterior length of the spinal cord (ALSC), the posterior length of the spinal cord (PLSC), the diameter of the vertebral canal (DVC) and the diameter of the spinal cord (DSC). Results: The ALSC and PLSC were longer in flexion than in extension and neutral position, with statistically significant difference between the flexion and extension position. The DVC and the DSC were greater in flexion than in extension and neutral position, however, there was no statistically significant difference when they were compared in the neutral, flexion and extension positions. Conclusion: Dynamic MRI allows to evaluate morphometric variations in the cervical spinal canal in patients with cervical spondylotic myelopathy.

DISLOCATION OF THE CERVICAL SPINE WITH CORD COMPRESSION IN RHEUMATOID ARTHRITIS

1974 ◽  
Vol 56-B (4) ◽  
pp. 668-680 ◽  
Author(s):  
K. A. E. Meijers ◽  
G. Th. Van Beusekom ◽  
W. Luyendijk ◽  
F. Duijfjes
Keyword(s):  
Rheumatoid Arthritis ◽  
Cervical Spine ◽  
Cord Compression

Evaluation of flexion/extension of the upper cervical spine in patients with rheumatoid arthritis: an MRI study with a dedicated positioning device compared to conventional radiographs

2005 ◽  
Vol 46 (1) ◽  
pp. 55-66 ◽  
Author(s):  
J. O. Karhu ◽  
R. K. Parkkola ◽  
S. K. Koskinen
Keyword(s):  
Rheumatoid Arthritis ◽  
Cervical Spine ◽  
Healthy Subjects ◽  
Upper Cervical Spine ◽  
Imaging Method ◽  
Neutral Position ◽  
Segmental Motion ◽  
Flexion Extension ◽  
Upper Cervical ◽  
Positioning Device

Purpose: Using flexion/extension magnetic resonance imaging (MRI) with a dedicated positioning device, our purpose was to analyze pathologic cranio‐vertebral joint anatomy and motion in patients with rheumatoid arthritis in comparison to normal patients, and to compare flexion/extension MRI with conventional radiographs (CRs) in patients with rheumatoid arthritis. Material and Methods: The 31 patients with rheumatoid arthritis and 20 healthy subjects included in the study were imaged in an open MRI scanner during flexion/extension. A dedicated positioning device was used. Additionally, we compared flexion/extension MRI with CRs in patients with rheumatoid arthritis. In MRI, the orientation and segmental motion of C0, C1, and C2 were assessed and structure of the dens and amount of pannus tissue were observed. Configuration of the cerebrospinal fluid space and the cord was evaluated in each position. In both MRI and CRs, anterior atlanto‐axial subluxation and vertical dislocation were assessed and sagittal diameter of the dural sac was measured. Results: In the neutral position, C1 of the patients was oriented in a more flexed position in relation to both C0 and C2 compared to that in healthy subjects. The patients had more extension in the upper cervical spine than did healthy subjects. In flexion, atlanto‐axial subluxation was greater in CRs than in MRI. In MRI, the amount of vertical dislocation did not depend on position. In the patients, there was considerably more cord impingement in flexion than in other positions. Conclusion: Evaluation of the rheumatoid cervical spine is optimized using MR images in the neutral, flexed, and extended positions. Measurements and relationships between structures should be compared in all positions. CRs with flexion‐extension views are recommended as the first imaging method.

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