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MRI of the Cervical Spine with Flexion and Extension

Basics: What is an MRI of the Cervical Spine with Flexion, Extension, and Cine?

In addition to obtaining the standard images of the cervical spine (see MRI of the Cervical Spine), sagittal Vibe and T2 images are obtained in full passive flexion and extension. With the patient in the MRI machine, they are asked to gently flex their neck and then extend their neck. In each position MRI images are obtained. Also, real time imaging with dynamic haste sequences are obtained while the patient is moving their neck and head from flexion to neutral to extension, and again back to neutral. (Movie Below). Conducting the exam in multiple positions allows the spine to be assessed for stability (translation of the vertebrae with respect to each other during movement),  and also permits evaluating how the curvature changes over time during movement. This information can help explain abnormal movements possibly indication how compensation, due to a prior injury, contributes to a misalignment.  This dynamic sequence is also very helpful  in ascertaining the relative mobility and angulation at each disc space during flexion and extension.

  

 

Discussion of images above:

There is abnormal motion of the cervical spine with hypermobility during flexion and extension at levels C4/5 and C5/6 in the study above.
No signs of abnormal translation/instability of the cervical spine during flexion and extension are present.

 

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