{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T18:10:44Z","timestamp":1777659044395,"version":"3.51.4"},"reference-count":13,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2015,7,9]],"date-time":"2015-07-09T00:00:00Z","timestamp":1436400000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2016,3]]},"abstract":"\n Study Design<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n The objective was to measure the change of flavum ligament diameter during positional changes of the cervical spine using kinetic magnetic resonance imaging (MRI) and to examine the correlational diameter changes of the flavum ligament, disk bulging, and the spinal canal from extension to flexion positions.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n One hundred eight-nine patients underwent kinetic MRI in neutral, extension, and flexion positions. The diameters of cervical ligamentum flavum, disk bulging, and cervical spinal canal and the disk degeneration grade and Cobb angles were measured from C2\u2013C3 to C7\u2013T1.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n In all, 1,134 cervical spinal segments from 189 patients were included. There was a 0.26\u2009\u00b1\u20090.85-mm average increase in the diameter of the ligamentum flavum from flexion to extension, and 62.70% of the segments had increased ligamentum flavum diameter from flexion to extension. For all segments of the 189 patients, the cervical spinal canal diameters had an average decrease at the disk level of 0.56\u2009\u00b1\u20091.21\u2009mm from flexion to extension. For all segments with cervical spinal canal narrowing \u22651\u2009mm from flexion to extension view, the ligamentum flavum diameters at C3\u2013C4 to C5\u2013C6 had significant increases compared with patients with spinal canal narrowing\u2009<\u20091\u2009mm ( p\u2009<\u20090.05). For patients with ligamentum flavum hypertrophy of \u22651\u2009mm from the flexion to extension view, the cervical spinal canal diameters at C2\u2013C3, C4\u2013C5, and C5\u2013C6 had significant decreases compared with patients with ligamentum flavum hypertrophy of <1\u2009mm ( p\u2009<\u20090.05).<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The \u201chidden\u201d hypertrophy of ligamentum flavum was significant at C4\u2013C5 and C5\u2013C6 and significantly contributes to the stenosis of cervical spinal canal in the extension position.<\/jats:p>\n <\/jats:sec>","DOI":"10.1055\/s-0035-1557140","type":"journal-article","created":{"date-parts":[[2015,7,9]],"date-time":"2015-07-09T18:54:42Z","timestamp":1436468082000},"page":"155-163","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["The Evaluation and Observation of \u201cHidden\u201d Hypertrophy of Cervical Ligamentum Flavum, Cervical Canal, and Related Factors Using Kinetic Magnetic Resonance Imaging"],"prefix":"10.1177","volume":"6","author":[{"given":"Cheng","family":"Zeng","sequence":"first","affiliation":[{"name":"Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedics, Peking University People's Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey C.","family":"Wang","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery and Neurosurgery, USC Spine Center, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirokazu","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California at Los Angeles, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanlin","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California at Los Angeles, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haijun","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California at Los Angeles, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bayan","family":"Aghdasi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California at Los Angeles, Los Angeles, California, United States"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2015,7,9]]},"reference":[{"key":"bibr1-s-0035-1557140","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0b013e31815f2556"},{"key":"bibr2-s-0035-1557140","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199011010-00012"},{"key":"bibr3-s-0035-1557140","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2010.04.035"},{"key":"bibr4-s-0035-1557140","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181b20054"},{"key":"bibr5-s-0035-1557140","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200109010-00011"},{"key":"bibr6-s-0035-1557140","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/94315429"},{"key":"bibr7-s-0035-1557140","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-04547-9_6"},{"key":"bibr8-s-0035-1557140","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-005-2666-4"},{"key":"bibr9-s-0035-1557140","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/89.1.27"},{"issue":"1","key":"bibr10-s-0035-1557140","first-page":"66","volume":"103","author":"Jia L S","year":"1990","journal-title":"Chin Med J (Engl)"},{"key":"bibr11-s-0035-1557140","doi-asserted-by":"publisher","DOI":"10.1097\/01.bsd.0000190816.28682.83"},{"key":"bibr12-s-0035-1557140","doi-asserted-by":"publisher","DOI":"10.1097\/01.brs.0000188117.77657.ee"},{"key":"bibr13-s-0035-1557140","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181604501"}],"container-title":["Global Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1055\/s-0035-1557140","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1055\/s-0035-1557140","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1055\/s-0035-1557140","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T07:17:56Z","timestamp":1777447076000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1055\/s-0035-1557140"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,7,9]]},"references-count":13,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2016,3]]}},"alternative-id":["10.1055\/s-0035-1557140"],"URL":"https:\/\/doi.org\/10.1055\/s-0035-1557140","relation":{},"ISSN":["2192-5682","2192-5690"],"issn-type":[{"value":"2192-5682","type":"print"},{"value":"2192-5690","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,7,9]]}}}