gms | German Medical Science

64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

3T kinematic MRI of the cervical spine for evaluation of adjacent level diseases after cervical disc arthroplasty: Results after 12 months follow-up

Meeting Abstract

  • Steffen Fleck - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald
  • Soenke Langner - Institut für Radiologie und Neuroradiologie Universitätsmedizin Greifswald, Greifswald
  • Rebecca Seipel - Institut für Radiologie und Neuroradiologie Universitätsmedizin Greifswald, Greifswald
  • Christian Rosenstengel - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald
  • Jan-Uwe Müller - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald
  • Henry W. S. Schroeder - Klinik und Poliklinik für Neurochirurgie, Universitätsmedizin Greifswald, Greifswald

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocMO.02.01

doi: 10.3205/13dgnc010, urn:nbn:de:0183-13dgnc0109

Published: May 21, 2013

© 2013 Fleck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: We sought to prospectively evaluate the signal intensity (SI) of adjacent disc spaces before and after cervical disc arthroplasty using 3T kinematic MRI studies to further understand structural alterations following cervical spine operations.

Method: 32 patients underwent cervical disc arthroplasty (Bryan®, Medtronic) (17 females, 15 males; age range 18-50). To date, 20 patients have been assessed both pre- and post-operatively (follow-up at 6 and 12 months) with 3 T MRI (Magnetom Verio, SIEMENS). During MRI, the cervical spine was positioned (flexion, extension, and neutral positions) using positioning pillows. T2 3D-SPACE and T2 TSE sequences were taken and axial views were reconstructed. We focused on SI changes of all non-operated disc levels to reveal developing adjacent level disease. We analyzed the SI with respect to fat tissue of 210 discs using ROI analysis (Osirix®). The Mann-Whitney test was used for statistical analyses (PASW®, vers.18).

Results: Non-operated disc space SI did not differ between pre- and post-op evaluations (p≥0.5). Furthermore, no significant SI changes were present in adjacent disc levels above (p=0.3) or below the operated level (p=0.8) 6 months following surgery. No significant differences were observed on 12 month follow-up. A strong correlation was observed between range of motion (ROM) in functional plain radiographs and in MRI and did not differ significantly.

Conclusions: This study revealed that kinematic cervical spine imaging in a wide-bore 3 T MRI is feasible and that there were no degenerative changes in adjacent cervical levels following disc arthroplasty on 6 and 12 month follow-up. A longer follow-up period and comparisons with fusion operations may be necessary to evaluate reduced adjacent level degenerations after cervical prosthesis operations in contrast to fusion.