Predictors of symptomatic myelopathy in degenerative cervical spinal cord compression

Autor: Zdenek Kadanka, Blanka Adamova, Milos Kerkovsky, Ladislav Dusek, Barbora Jurova, Eva Vlckova, Josef Bednarik
Rok vydání: 2017
Předmět:
Adult
Male
medicine.medical_specialty
cervical radiculopathy
Asymptomatic
Spinal Cord Diseases
predictive model
03 medical and health sciences
Behavioral Neuroscience
Myelopathy
0302 clinical medicine
Humans
Medicine
Prospective Studies
030212 general & internal medicine
Physical Examination
Cervical canal
Aged
Original Research
medicine.diagnostic_test
business.industry
Magnetic resonance imaging
Cervical cord compression
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Hyperintensity
3. Good health
Surgery
nonmyelopathic degenerative cervical cord compression
Diffusion Tensor Imaging
medicine.anatomical_structure
degenerative cervical myelopathy
Cohort
Cervical Vertebrae
Disease Progression
Female
Radiology
medicine.symptom
business
Spinal Cord Compression
030217 neurology & neurosurgery
Follow-Up Studies
Diffusion MRI
Zdroj: Brain and Behavior
ISSN: 2162-3279
DOI: 10.1002/brb3.797
Popis: Objectives To update a previously established list of predictors for neurological cervical cord dysfunction in nonmyelopathic degenerative cervical cord compression (NMDCCC). Material and Methods A prospective observational follow‐up study was performed in a cohort of 112 consecutive NMDCCC subjects (55 women and 57 men; median age 59 years, range 40–79 years), either asymptomatic (40 subjects) or presenting with cervical radiculopathy or cervical pain (72 subjects), who had completed a follow‐up of at least 2 years (median duration 3 years). Development of clinical signs of degenerative cervical myelopathy (DCM) as the main outcome was monitored and correlated with a large number of demographic, clinical, electrophysiological, and MRI parameters including diffusion tensor imaging characteristics (DTI) established at entry. Results Clinical evidence of the first signs and symptoms of DCM were found in 15 patients (13.4%). Development of DCM was associated with several parameters, including the clinical (radiculopathy, prolonged gait and run‐time), electrophysiological (SEP, MEP and EMG signs of cervical cord dysfunction), and MRI (anteroposterior diameter of the cervical cord and cervical canal, cross‐sectional area, compression ratio, type of compression, T2 hyperintensity). DTI parameters showed no significant predictive power. Multivariate analysis showed that radiculopathy, cross‐sectional area (CSA) ≤ 70.1 mm2, and compression ratio (CR) ≤ 0.4 were the only independent significant predictors for progression into symptomatic myelopathy. Conclusions In addition to previously described independent predictors of DCM development (radiculopathy and electrophysiological dysfunction of cervical cord), MRI parameters, namely CSA and CR, should also be considered as significant predictors for development of DCM.
Databáze: OpenAIRE
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