In the Journals

Flexion extension MRI protocol can help reveal undetected stenosis

Researchers found dynamic MRI is an important tool that may help detect cervical spinal stenosis in cases where standard MRI may not.

A total of 51 consecutive patients with cervical spondylotic myelopathy who underwent dynamic MRI in the neutral, flexion and extension positions of the cervical spine from levels C3-C7 were selected for inclusion in the study. Patients were retrospectively evaluated with regard to canal stenosis and the presence of absence of hyperintense intramedullary lesions (HILs).

Of the 255 levels evaluated in three positions, the researchers found the stages in extension were higher than the stages in the neutral and flexion positions at each level. For the C3-C6 levels, approximately 22.5% of the Stage-3 levels were classified as Stage-1 levels in the neutral position.

HILs were observed to be better identified in the flexion position compared with the neutral and extension positions. Additionally, the researchers found that 10% of patients, HILs were identified only when using the T2-weighted sequence in flexion.

The researchers concluded extension MRI helped to identify HILs not detected in standard MRI, and that preoperative extension MRI can help a surgeon determine the accurate levels to surgically decompress. – by Robert Linnehan

Disclosure: The researchers report no relevant financial disclosures.

Researchers found dynamic MRI is an important tool that may help detect cervical spinal stenosis in cases where standard MRI may not.

A total of 51 consecutive patients with cervical spondylotic myelopathy who underwent dynamic MRI in the neutral, flexion and extension positions of the cervical spine from levels C3-C7 were selected for inclusion in the study. Patients were retrospectively evaluated with regard to canal stenosis and the presence of absence of hyperintense intramedullary lesions (HILs).

Of the 255 levels evaluated in three positions, the researchers found the stages in extension were higher than the stages in the neutral and flexion positions at each level. For the C3-C6 levels, approximately 22.5% of the Stage-3 levels were classified as Stage-1 levels in the neutral position.

HILs were observed to be better identified in the flexion position compared with the neutral and extension positions. Additionally, the researchers found that 10% of patients, HILs were identified only when using the T2-weighted sequence in flexion.

The researchers concluded extension MRI helped to identify HILs not detected in standard MRI, and that preoperative extension MRI can help a surgeon determine the accurate levels to surgically decompress. – by Robert Linnehan

Disclosure: The researchers report no relevant financial disclosures.