Dynamic cervical spine models have been static in the past.
Research demonstrates MRI can show problems like disc bulge and disc herniation even though patients do not have symptoms. Interestingly, there has been a shift in clinical thinking that many MRIs are ordered unnecessarily and can lead to unnecessary surgery.
What we are beginning to learn is that specific MRI imaging may be better at looking at pain generators in the cervical spine. In a recent publication in the Journal of Orthopedic Science, these researchers looked at T2 mapping as a way to indicate whether the discs are symptomatic or not.
This has always been the problem with MRI imaging. Most pain generators are dynamic in nature. That is, most of a patient’s pain comes with moving in certain direction or moving in a certain direction for an extended period of time. To date, the only way we were to determine whether the interevertebral disc is painful, is use of the gold standard discogram.
This is an invasive procedure that pokes the disc, with a needle, and over inflates it, like a tire, to see how much pain can be generated in the patient. The problem with this procedure is that if you poke a disc it begins to degenerate. Researchers use this model to study degeneration.
T2 mapping MRI is non-invasive–at least we have no evidence, yet, to suggest it is. And T2 mapping is also suggestive that it is looking at the water content of the intervertebral discs.
The future of understanding pain generators of the spine will be a the careful analysis of disc height loss, water content of the nucleus pulposus, and dynamic MRI imaging.
An accurate and dynamic cervical spine model can help explain load related pain generators like disc bulging and disc herniation. Treatments targeting the restoration of disc heights and the lordotic curve will lead the way in decades to come. Dynamic Disc Designs produces models to encourage research and education.