Clinical value of kinematic MR imaging in the evaluation of patients with exacerbated pain in cervical spine motion.

Objective: To assess the clinical value of kinematic MR imaging in patients with cervical radiculopathy and increasing symptoms after provocative mane uvers at flexion, extension, axial rotation and coupled motion of the cervi cal spine. Methods: Thirty-five patients with cervical disc herniation or c ervical spondylosis in whom symptoms were elicited at flexion, extension, a xial rotation and coupled motion were studied inside a positioning device u sing T-2-weighted TSE, 2D-FLASH, and reformatted 3D DESS and 3D-FISP sequen ces. The images were evaluated for the size of disc herniations, the forami nal size and cervical cord displacement at provocative position compared wi th neutral position (0 degrees). In addition, the value of kinematic MR ima ges were interpretated with regard to changes in the therapeutic procedure and intraoperative patient positioning. Results: Compared with the neutral position (0 degrees) a change in disc herniations was not found in any (0%) of the provocative positions. In five patients (14%) cervical cord displac ement was noted at axial rotation. The foraminal size varied depending on t he provocative position, increasing at flexion and decreasing at extension. Conclusion: Kinematic MR imaging in patients with cervical radiculopathy a nd increasing symptoms at provocative maneuvers provides no additional info rmation for the therapeutic decision-malting process.