Dynamic Flexion-Extension Magnetic Resonance Imaging of the Cervical Spine: An Evolutionary Tool for Diagnosis and Management of Cervical Spondylotic Myelopathy

World Neurosurg. 2024 Apr:184:138-147. doi: 10.1016/j.wneu.2024.01.081. Epub 2024 Jan 20.

Abstract

Dynamic problems need dynamic solutions. High motility of the cervical spine causes a common age-related degenerative condition called cervical spondylotic myelopathy (CSM), manifested by neurological impairments. An accurate and reliable diagnosis of CSM is crucial for determining appropriate management strategies. Traditional static magnetic resonance imaging (MRI) has been the gold standard for imaging CSM; however, it may not fully capture dynamic changes during neck movement. Dynamic flexion-extension (DFE) MRI is an innovative imaging technique that allows for real-time visualization of cervical spine motion. This review article aims to scrutinize the role of DFE MRI in assessing CSM, its added value to clinical implementations, and its limitations. Finally, by addressing the knowledge gaps, this survey sheds light on the road ahead to incorporate DFE MRI into a standard version of the practice.

Keywords: Cervical spondylotic myelopathy (CSM); Dynamic; Flexion-extension; Magnetic resonance imaging (MRI); Spinal cord diseases.

Publication types

  • Review

MeSH terms

  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / pathology
  • Humans
  • Magnetic Resonance Imaging / methods
  • Range of Motion, Articular
  • Spinal Cord Diseases* / diagnostic imaging
  • Spinal Cord Diseases* / surgery
  • Spondylosis* / diagnostic imaging
  • Spondylosis* / surgery