Cervical spine and cord angle mismatch in the pathogenesis of myelopathy.

Related Articles

Cervical spine and cord angle mismatch in the pathogenesis of myelopathy.

World Neurosurg. 2018 Apr 13;:

Authors: Tykocki T, du Plessis J, Wynne-Jones G

Abstract
BACKGROUND: Cervical myelopathy is a complex pathology and dynamic compression of the tethered cervical cord may be responsible for clinical symptoms METHODS: Patients with cervical canal stenosis who had magnetic resonance imaging (MRI) in flexion (F) and extension (E) positions were retrospectively reviewed. All cases were evaluated in Nurick grade. Based on MRI following cervical parameters were measured: cervical cord angle (CCA), cervical lordosis (C lordosis), spine/cord (S/C) angle ratio. Mean values of parameters were compared between non-myelopathic (Nurick grade 0) and myelopathic groups (grades 1-5). A multinomial ordinal logistic regression was used to predict outcome for Nurick grade using CC angle, C lordosis angle and S/C ratio as independent variables.
RESULTS: 65 patients, 35 men; with the mean age of 58.6±11.4 years were analysed.A comparison of means between Nurick grade 0 against each of myelopathic grades 1-5 revealed significant differences only for S/C angle ratio. A cumulative comparison between non-myelopathic and myelopathic grades for S/C angle ratio showed significant difference of 0.29 (1.16±0.5 vs. 1.45±0.6 respectively; p<0.05). Cumulative comparison for CC angle difference in F-E and C lordosis difference in F-E did not show substantial differences. S/C angle ratio was the only significant parameter in the prediction of the Nurick grades with an odds ratio of 2.63 (95% CI, 2.11-2.79).
CONCLUSIONS: A positive correlation between Nurick grade and cervical spine and cord angle mismatch (S/C angle ratio) was found.

PMID: 29660552 [PubMed - as supplied by publisher]

https://ift.tt/2HuiBCc