Correlation of the dynamic cervical magnetic resonance imaging findings with standard static magnetic resonance imaging and clinical findings in degenerative cervical disease

The aim of this study is to evaluate the differences between static and dynamic magnetic resonance imaging (MRI) findings in patients with degenerative cervical disease and to investigate the correlation between clinical and dynamic MRI findings. 84 patients admitted to our hospital with complaints of neck pain, were included in the study. During the clinical examination before MRI, the patients were evaluated with visual analog scale (VAS) and neck disability index (NDI) forms. Kang score (KS), ligamentum flavum (LF) thickness, spinal canal anteroposterior diameter (SCD), sagittal range of motion (ROM) among the C3-C7 levels were measured on static cervical MRI and the same measurements were repeated on dynamic MRI. The data obtained from the MRI in neutral, flexion and extension positions were compared statistically and the relationship between MRI findings and VAS and NDI scores were also evaluated. The mean age of 84 patients (55 females, 29 males) included in the study is 51.32 ± 7.29 years. Positive correlation was found between KS and VAS scores on C4-5 and C6-7 levels in neutral position (P <0.05), on C4-5 and C6-7 levels in flexion position (P <0.05), on C4-5 and C6-7 levels in extension position (respectively P <0.05; P < 0.01). There was a difference between KS at neutral-extension and flexion-extension positions at all levels (P <0.05, P <0.01, respectively). There was found a negative relationship between the VAS score and LF thickness in flexion position on level of C6-7 (P <0.05). There were differences in LF thickness at neutral, flexion and extension positions at all levels (P <0.01). A negative correlation was found between SCD and VAS score in flexion position (P <0.05) at C4-5 level. A significant difference was found between the values of SCD in neutral, flexion and extension positions at all levels (p <0.01). A positive correlation was found between SCD and ROM measured at C4-5 and C6-7 levels in flexion (P <0.05; P <0.01, respectively). A negative correlation was found between SCD and ROM measured at C6-7 level in extension (P <0.05). There was a negative correlation between KS and ROM measured at C6-7 levels in flexion (p <0.05). Our study showed that dynamic MRI is superior to static MRI in imaging of cervical canal stenosis and the factors contributing to this condition. The use of dynamic MRI in addition to standard inspection may be useful for diagnose, treatment and operation planning of degenerative cervical disease. However, this method is not suitable for each patient in terms of patient comfort, time and cost. Our study shows that the use of physical examination, neck pain and disability forms in order to determine the need for additional examination does not contribute sufficiently. We think that this relationship can be demonstrated by studies with patients who have symptoms of myelopathy and radiculopathy rather than patients with axial neck pain alone.