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| To investigate the correlation between the segmental activity of the functional units and extent ofthe vertebral canal stenosis in the lower cervical spine |
| ZHANG Xiao-guang1, WANG Shu-li1, ZHANG Xiao-lin1, PAN Tao1, CUI Zhuang2 |
| 1.Tianjin Hospital, Tianjin 300211, China; 2.College of Public Health, Tianjin Medical University, Tianjin 300211, China |
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Abstract Objective: To investigate relationships between the degree of the cervical spinal canal stenosis and lower cervical segmental stability in patients with cervical spondylotic myelopathy(CSM). Methods: Sixty-two patients with CSM for prepared surgery were examined with the lateral dynamic radiographs(flexion-extension) and MR scanner. Radiographic evaluation included the C2~C7 Cobb angle and FSU-Cobb angle at C3~C4, C4~C5, and C5~C6. Cervical spinal stenosis was classified by means of the T2-weighted MR images into four grades. Radiological change was analyzed according to the degree of the spinal stenosis during flexion-extension motion. Results: The segmental activity of the C4~C5, C5~C6 was greater than that at the C3~C4 in Grade Ⅰ spinal stenosis, and statistical difference was observed between the C4~C5 and the C3~C4. The segmental activity at the C4~C5 decreased significantly in Grade Ⅲ compared with Grade Ⅰ and Grade Ⅱ spinal stenosis, and implied the segmental units at the C4~C5 contributed the majority of the mobility on the cervical spine and motion decreased in the severe spinal stenosis. There was no statistical difference on the range of the motion of the overall cervical spine between grade 0~Ⅱ and grade Ⅲ groups. Conclusion: The functional spinal unit(FSU) is the smallest functional unit of the cervical spine and exhibits the generic characteristics of the spine. The mobility of the FSU was significantly reduced in the severe cervical spinal stenosis, from an unstable phase to an ankylosed stage, with the progression of the degenerative change. Hence, combined application of the common lateral dynamic radiographs and MRI in judging the activity of the cervical spine and spinal canal stenosis plays an important role in the clinical practice.
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Received: 20 May 2011
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2012, Vol. 23 
