Artikel
Spinal degenerative changes correlate with the development of degenerative cervical myelopathy
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Autoren
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Bryn Hilton
- University of Cambridge, Department of Clinical Neurosciences, Academic Neurosurgery Unit, Cambridge, United Kingdom
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Benjamin Davies
- University of Cambridge, Department of Clinical Neurosciences, Academic Neurosurgery Unit, Cambridge, United Kingdom
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Mark Kotter
- University of Cambridge, Department of Clinical Neurosciences, Academic Neurosurgery Unit, Cambridge, United Kingdom
| Veröffentlicht: | 9. Juni 2017 |
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Gliederung
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Objective: Degenerative cervical myelopathy (DCM) is spinal cord compression due to degenerative changes in the surrounding spine. The study examines the prevalence of key pathological changes in the cervical spine that increase the likelihood of a patient being clinically myelopathic
Methods: A retrospective cohort of 281 patients receiving a cervical spine MRI scan in a 3 month period at a tertiary neurosciences centre. All cervical spine MRI scans were examined for reported pathological features. A comparison was made between myelopathic patients with cord compression, non-myelopathic patients with cord compression, and non-myelopathic patients without cord compression. Chi squared analysis was conducted to identify statistically significant pathological differences between groups.
Results: DCM MRI scans showed significantly higher rates of osteophytosis, ligamentous pathology, and T2 hyperintensity than the spines of non-myelopathic patients (p<0.01). DCM patients averaged 3.25 key degenerative changes whereas non-myelopathic patients with cord compression averaged 1.8 (Z=-5.6, p<0.05). 69% of DCM had cord “compression”. The remaining 31% had other terminology used to describe their cord compromise. Number of degenerative changes did not correlate with disease severity at time of scan (R2=0.08, p=0.36) or at surgical assessment (R2=0.28, p=0.11).
Conclusion: In patients with MRI confirmed cervical cord compression, clinical myelopathy was associated with more degenerative spinal changes. The number of changes did not correlate with myelopathy severity.
