Magnetic Resonance Imaging Findings of Fatty Infiltrate in the Cervical Flexors in Chronic Whiplash
From: Spine (Phila Pa 1976). 2010 Jan 28. [Epub ahead of print]
Retrospective investigation of muscle changes in patients suffering from chronic whiplash associated disorders. The objective was to quantitatively compare the presence of muscle alterations (fatty infiltrate and cross-sectional area) in the anterior musculature of the cervical spine in a cohort of chronic whiplash patients (whiplash associated disorders II) and healthy control subjects across muscle and cervical segmental level.
Magnetic resonance imaging can be regarded as the gold standard for muscle imaging. There is little knowledge about in vivo features of anterior neck muscles in patients suffering from chronic whiplash associated disorders and how muscle structure differs across the factors of muscle, vertebral level, age, self-reported pain and disability, body mass index, and duration of symptoms.
Reliable magnetic resonance imaging measures for fatty infiltrate and cross-sectional area were performed for the anterior cervical muscles bilaterally in 109 female subjects (78 whiplash associated disorders, 31 healthy control; 18-45 years, 3 months to 3 years post injury). The measures were performed on all subjects for the longus capitis and longus colli and the sternocleidomastoid muscles.
The whiplash associated disorders subjects had significantly larger fatty infiltrate and cross-sectional area for the anterior muscles compared to healthy control subjects. In addition, the amount of fatty infiltrate varied by both cervical level and muscle, with the longus capitis and longus colli having the largest amount of fatty infiltrates at the C2-C3 level. Fatty infiltrate was inversely related to age, self-reported pain and disability, and body mass index but directly proportional to duration of symptoms.
There is significantly greater fatty infiltrate and cross-sectional area in the anterior neck muscles, especially in the deeper longus capitis and longus colli muscles, in subjects with chronic whiplash associated disorders when compared to healthy controls. Future studies are required to investigate the relationships between muscular morphometry and symptoms in patients suffering from acute and chronic whiplash associated disorders.
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