THE NATURAL-HISTORY OF THE CERVICAL FORAMEN IN SYMPTOMATIC AND ASYMPTOMATIC INDIVIDUALS AGED 20-60 YEARS AS MEASURED BY MAGNETIC-RESONANCE-IMAGING - A DESCRIPTIVE APPROACH

Study Design. This study was intended to identify normal degenerative morphologic evolution in the bony foramen in asymptomatic subjects by decade in comparison with symptomatic subjects of like decades. Object ives. To determine normal degenerative changes in the cervical spine c aused by the aging process that predispose a person to foraminal steno sis and; radiculopathy. Summary of Background Data. Cervical radiculop athy is a common problem caused by degenerative changes as people age. The characteristics of the foramen that result in stenosis are not kn own. Methods. Five to six symptomatic and asymptomatic people in each decade volunteered for magnetic resonance imaging. Lordosis, disc heig hts, and ratio of spinal cord diameter to spinal canal diameter were m easured at C4-C5, C5-C6, and C6-C7 from sagittal magnetic resonance im ages. Foraminal heights, widths, and areas were measured at the isthmu s of the same foramen from oblique images. Results. Foraminal heights, widths, and areas were; larger in symptomatic patients than in sympto matic patients. Morphologic analysis showed that inferior facet hypert rophy tended to decrease the width of the foramen in aging people. Dis c heights, lordosis, and ratio of spinal cord diameter to spinal canal diameter showed no significant differences. Conclusions. Foraminal he ight affects overall foraminal area but tends to change little with ag e. Width also affects overall area and not only decreases in older peo ple but also significantly affects the available area for the exiting nerve root.