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The effects of the degenerative changes in the functional spinal unit on the kinematics of the cervical spine
Yuichiro Morishita1, Shinichi Hida, Masashi Miyazaki
1Department of Orthopaedic Surgery, University of California at Los Angeles, Los Angeles, CA, USA.
Study Design:
The sagittal kinematics of the cervical spine was evaluated using kinematic magnetic resonance imaging (kMRI).
Objective:
To investigate the effect of degenerative changes in the functional spinal unit on cervical kinematics by using kMRI.
Summary Of Background Data:
Few studies have, thus far, by using MR images, described the contribution of degenerative changes in the functional spinal unit to cervical kinematics; however, the exact cervical kinematics remains uncertain.
Methods:
A total of 289 consecutive symptomatic patients underwent dynamic cervical MRI in flexion, neutral, and extension postures. All digital measurements and calculations of the variations in segmental angular motion were automatically performed by an MR analyzer using true MR images with 77 predetermined points marked on each image. Each segment was assessed based on the extent of intervertebral disc degeneration (Grades 1-3) and cervical cord compression (groups A-C) observed on T2-weighted MR images.
Results:
The segmental mobility of the segments with severe cord compression and moderate disc degeneration tended to be lower than that of the segments with severe cord compression and severe disc degeneration, and a significant difference was observed in the segmental mobility of the C5-C6 segment. Moreover, in all segments with moderate disc degeneration, the segmental mobility was significantly reduced in the presence of severe cord compression, as compared with no compression. However, in segments with severe disc degeneration, no significant differences were observed between the segmental mobility of the cord compression groups.
Conclusion:
Our results suggest that cervical cord compression may cause deterioration of cervical cord function and kinematic changes in the cervical spine. We hypothesize that the spinal cord may potentially protect its functions from dynamic mechanical cord compression by restricting segmental motion, and these mechanisms may be closely related to the intervertebral discs.
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