Kinematic Magnetic Resonance Imaging to Define the Cervical Facet Joint Space for the Spine in Neutral and Torsion
Kinematic Magnetic Resonance Imaging to Define the Cervical Facet Joint Space for the Spine in Neutral and Torsion
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DOI：
10.1097/brs.0000000000000206
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发表时间：
2014-04-15
期刊：
影响因子：
3
通讯作者：
Winkelstein, Beth A.
中科院分区：
文献类型：
--
作者：
Jaumard, Nicolas V.;Udupa, Jayaram K.;Winkelstein, Beth A.
研究设计. Proximity采集正常受试者和神经根病患者颈部的磁共振图像，以测量和比较小关节间隙厚度和体积的测量值。目的是确定两个人群之间的小关节结构是否有任何差异，头部在中立和疼痛诱发旋转。小关节的退化和力学改变可导致病理性神经根压迫和疼痛。虽然腰椎小关节间隙变薄已被报道在下腰痛的背景下，很少有研究量化的颈椎小关节间隙，特别是在疼痛的背景下。在3T磁共振扫描仪中，使用针对骨成像优化的T2脉冲序列，对8例有症状受试者和10例无症状受试者的颈椎进行矢状面成像。在获取的图像中识别并分割小关节间隙。通过三维图像计算两侧颈椎节段小关节间隙的厚度和体积及其在不同位置之间的变化。一般来说，小关节间隙的厚度和体积在有症状的受试者小于无症状的受试者。左侧的差异更明显，尤其是在中性和左侧扭转方面。在两个人群之间，从中性到扭转的体积和厚度变化在单独关节水平上的标志和幅度也不同。结论。使用标准磁共振成像序列对神经根病患者颈椎小关节间隙结构进行量化是可行的。从无痛和疼痛位置测量小关节间隙厚度和体积及其变化，可以为定位疼痛组织负荷的潜在来源提供背景。
Study Design. Prospectively acquire magnetic resonance images of the neck in normal subjects and patients with radiculopathy to measure and compare measures of the facet joint space thickness and volume.Objective. The goal was to determine whether there is any difference in facet joint architecture between the 2 populations with the head in each of neutral and pain-eliciting rotation.Summary of Background Data. Degeneration and altered mechanics of the facet joint can result in pathological nerve root compression and pain. Although lumbar facet joint space thinning has been reported in the context of low back pain, few studies have quantified the cervical facet joint space, especially in the context of pain.Methods. The cervical spine of 8 symptomatic and 10 asymptomatic subjects was imaged in the sagittal plane in a 3T magnetic resonance scanner, using a T2-pulse sequence optimized for bone imaging. The facet joint space was identified and segmented in the acquired images. The thickness and volume of the facet joint space, and their changes between positions, were computed from the 3-dimensional representation for all cervical levels on both sides.Results. Generally, the facet joint space thickness and volume were smaller in the symptomatic subjects than in the asymptomatic subjects. The differences were more robust on the left, especially in neutral and left torsion. The changes in both volume and thickness from neutral to torsion were also different in sign and magnitude at isolated joint levels between the 2 populations.Conclusion. Quantification of the facet joint space architecture in the cervical spine of patients with radiculopathy is feasible using standard magnetic resonance imaging sequences. Measurements of the facet space thickness and volume, and their changes, from both pain-free and painful positions, can provide context for localizing potential sources of painful tissue loading.