Department of Radio-diagnosis Vinayaka Missions Kirupananda Variyar Medical College and Hospital · MDRD Professor & HOD Department of Radio-diagnosis Vinayaka Missions Kirupananda Variyar Medical College and Hospita · MDRD Associate Professor Department of Radio-diagnosis Vinayaka Missions Kirupananda Variyar Medical College and Hospital
Background:The cervical spine is a highly mobile region of the spine, with complex biomechanics that allow for flexion, extension, and rotation. The dural sac, which contains the spinal cord and nerve roots, is located within the vertebral canal. Previous studies have shown that spinal movements, such as flexion, can lead to dynamic changes in the shape and size of the posterior dural sac. Understanding these changes is important for evaluating conditions like spinal stenosis, herniated discs, and other pathologies that may affect the cervical spine. Magnetic resonance imaging (MRI) has emerged as a powerful tool for assessing these dynamic changes, providing clear visualization of soft tissues without the need for invasive procedures.
Objective:The aim of this study is to evaluate the widening of the posterior dural sac during flexion of the cervical spine using MRI, and to analyze how these changes may correlate with spinal pathology and clinical symptoms in patients.
Methods:A prospective cohort study was conducted, including 50 patients with complaints of neck pain and suspected cervical spine pathology. Each patient underwent MRI scans of the cervical spine in both neutral and flexed.The posterior dural sac width was measured at different cervical vertebral levels, and changes in sac size were noted during flexion. The results were compared with clinical findings, including pain scores, neurological symptoms, and history of cervical spine disorders.
Results:The study demonstrated significant widening of the posterior dural sac in the flexed position compared to the neutral position, particularly at the C5-C6 and C6-C7 levels. A strong correlation was observed between the degree of widening and the presence of disc herniation or spinal stenosis. Patients with greater widening also
reported more pronounced symptoms of radiculopathy and neck pain.
Conclusion:MRI evaluation of the cervical spine during flexion provides valuable insights into the dynamic changes in the posterior dural sac, which may contribute to the pathophysiology of cervical spine disorders. The findings suggest that flexion-induced widening of the dural sac could be a useful marker for diagnosing conditions
such as disc herniation and spinal stenosis, and may guide treatment strategies, including surgical intervention.
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