A nterior decompression and fusion of the cervical spine have become important in the treatment of degenerative cervical disease that causes myelopathy and radiculopathy. Techniques include ACD, ACDF, ACDFP, vertebral corpectomy, and corpectomy with placement of an anterior plate. The choice of technique depends on the number of levels of disease and the particular diagnosis. The authors of some studies 30 have cited graft collapse and settling as reasons for the use of a plate, whereas others 5 , 11 , 17 have cited enhancement of solid fusion, thus
Justin F. Fraser and Roger Härtl
Alex J. Koefman, Melissa Licari, Michael Bynevelt and Christopher R. P. Lind
An objective biomarker for pain is yet to be established. Functional MRI (fMRI) is a promising neuroimaging technique that may reveal an objective radiological biomarker. The purpose of this study was to evaluate fMRI technology in the setting of lumbosacral radiculopathy and discuss its application in revealing a biomarker for pain in the future.
A prospective, within-participant control study was conducted. Twenty participants with painful lumbosacral radiculopathy from intervertebral disc pathology were recruited. Functional imaging of the brain was performed during a randomly generated series of nonprovocative and provocative straight leg raise maneuvers.
With a statistical threshold set at p < 0.000001, 3 areas showed significant blood oxygen level–dependent (BOLD) signal change: right superior frontal gyrus (x = 2, y = 13, z = 48, k = 29, Brodmann area 6 [BA6]), left supramarginal cortex (x = −37, y = −44, z = 33, k = 1084, BA40), and left parietal cortex (x = −19, y = −41, z = 63, k = 354, BA5). With a statistical threshold set at p < 0.0002, 2 structures showed significant BOLD signal change: right putamen (x = 29, y = −11, z = 6, k = 72) and bilateral thalami (right: x = 23, y = −11, z = 21, k = 29; x = 8, y = −11, z = 9, k = 274; and left: x = −28, y = −32, z = 6, k = 21).
The results in this study compare with those in previous studies and suggest that fMRI technology can provide an objective assessment of the pain experience.