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Assesment of dynamic MRI for the evaluation of neck and back pain 2007

General Spine

Stephen L.G. Rothman, MD

Scientific Paper

Purpose

Dynamic MRI in the upright position has been reported to be helpful in the evaluation of patients with neural compression where symptoms occur in upright or sitting position rather than supine or at rest. These symptoms are rare, however, and the majority of patients are being scanned are being studied for back or neck pain. Dynamic scans generally cost 2 or 3 times as much as conventional MR scans because of the number of sequences. It is the purpose of this communication to review to usefulness of Dynamic MRI of the lumbar and cervical spine in assessing neck or back pain in an attempt to determine if the cost is justified.

Methods & Materials

Thirty five sets of dynamic scans of the cervical or lumbar spine were reviewed. All patient's had their scans in the context of being evaluated for back or neck pain following trauma. In none of the patients was the dominant symptom dynamic neural compression. An attempt was made to classify abnormalities as likely or unlikely due to trauma, and as likely, unlikely or indeterminate the cause of neck pain.

Results

In All cases the appearance of the discs changed in the different positions. In none of the case were these changes felt to be unphyiological. In none of the cases were any abnormalities felt to be likely due to the trauma being evaluated and in none of the cases was it possible to objectively diagnose the cause of the patient's pain from the MRI scan.

Conclusion

There is no justification for the added expense of performing dynamic MRI for neck or back pain because it is impossible to diagnose the cause of the pain from these studies.