颈椎病动态MRI扫描揭示椎管狭窄及脊髓受压因素的价值

Value of kinematic MRI in revealing factors of spinal canal stenosis and cord impingement in patients with cervical spondylosis

颈椎动态MRI扫描直观地显示屈伸状态下导致椎管狭窄及脊髓受压的动态因素,为临床提供了中立位扫描所不能揭示的致病机制,以后伸位为著。后伸位颈椎功能性受压与颈椎退变阶段及椎管矢径密切相关,当中立位MRI显示黄韧带肥厚,或椎关节僵硬伴发椎管矢径≤10.0mm时,建议行动态MRI扫描。前屈位虽然可以减轻脊髓受压,但持久前屈会促使或加重颈椎病的发生。

Different factors of spinal canal stenosis and cord impingement were described directly at fiexion, and especially, at extention in patients with cervical spondylosis by use of kinematic MRI. Compared with neutral position, additional information was provided. Functional cord impingement at extension MRI were related to degenerative stages and canal spaces. If patient had hypertrophy of ligamentum flavum or spondylosis with canal space of 10 mm or less, kinematic MRI was suggested. Cord impingement may alleviated at flexion, but lasting flexion can accelerated or aggravated cervical spondylosis.