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Narrow cervical canal in 1211 asymptomatic healthy subjects: the relationship with spinal cord compression on MRI

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Abstract

Purpose

Narrow cervical canal (NCC) has been a suspected risk factor for later development of cervical myelopathy. However, few studies have evaluated the prevalence in asymptomatic subjects. The purpose of this study was to investigate the prevalence of NCC in a large cohort of asymptomatic volunteers.

Methods

This study was a cross-sectional study of 1211 asymptomatic volunteers. Approximately 100 men and 100 women representing each decade of life from the 20s to the 70s were included in this study. Cervical canal anteroposterior diameters at C5 midvertebral level on X-rays, and the prevalence of spinal cord compression (SCC) and increased signal intensity (ISI) changes on MRI were evaluated. Receiver operating characteristic analysis was performed to determine the cut-off value of the severity of canal stenosis resulting in SCC.

Results

NCC (<14 mm) was observed in 123 (10.2 %) subjects. SCC and ISI were found in 64 (5.3 %) and 28 (2.3 %) subjects, respectively. The prevalence of NCC was significantly higher in females and older subjects, but the occurrence of severe NCC (<12 mm) did not increase with age. The canal size in subjects with SCC or ISI was significantly smaller than in those without SCC (p < 0.0001). The cut-off values of cervical canal stenosis resulting in SCC were 14.8 and 13.9 mm in males and females, respectively.

Conclusions

The prevalence of NCC was considerably lower among asymptomatic healthy volunteers; the cervical canal diameter in subjects with SCC or ISI was significantly smaller than in asymptomatic subjects; NCC is a risk factor for SCC.

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References

  1. Kalsi-Ryan S, Karadimas SK, Fehlings MG (2013) Cervical spondylotic myelopathy the clinical phenomenon and the current pathobiology of an increasingly prevalent and devastating disorder. Neuroscientist 19:409–421

    Article  PubMed  Google Scholar 

  2. Nouri A, Tetreault L, Singh A, Karadimas SK, Fehlings MG (2015) Degenerative cervical myelopathy: epidemiology, genetics and pathogenesis. Spine (Phila Pa 1976). doi:10.1097/brs.0000000000000913

    Google Scholar 

  3. Baptiste DC, Fehlings MG (2006) Pathophysiology of cervical myelopathy. Spine J Off J N Am Spine Soc 6:190s–197s. doi:10.1016/j.spinee.2006.04.024

    Article  Google Scholar 

  4. Karadimas SK, Erwin WM, Ely CG, Dettori JR, Fehlings MG (2013) The pathophysiology and natural history of cervical spondylotic myelopathy. Spine 38(22 Suppl 1):S21–S36

    Article  PubMed  Google Scholar 

  5. Kasai Y, Akeda K, Uchida A (2007) Physical characteristics of patients with developmental cervical spinal canal stenosis. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 16:901–903. doi:10.1007/s00586-007-0358-2

    Article  Google Scholar 

  6. Hayashi H, Okada K, Hamada M, Tada K, Ueno R (1987) Etiologic factors of myelopathy. A radiographic evaluation of the aging changes in the cervical spine. Clin Orthop Relat Res (214):200–209

  7. Inoue H, Ohmori K, Takatsu T, Teramoto T, Ishida Y, Suzuki K (1996) Morphological analysis of the cervical spinal canal, dural tube and spinal cord in normal individuals using CT myelography. Neuroradiology 38:148–151

    Article  CAS  PubMed  Google Scholar 

  8. Sasaki T, Kadoya S, Iizuka H (1998) Roentgenological study of the sagittal diameter of the cervical spinal canal in normal adult Japanese. Neurol Med Chir (Tokyo) 38:83–88 discussion 88–89

    Article  CAS  Google Scholar 

  9. Edwards WC, LaROCCA H (1983) The developmental segmental sagittal diameter of the cervical spinal canal in patients with cervical spondylosis. Spine 8:20–27

    Article  CAS  PubMed  Google Scholar 

  10. Torg JS, Naranja RJ Jr, Pavlov H, Galinat BJ, Warren R, Stine RA (1996) The relationship of developmental narrowing of the cervical spinal canal to reversible and irreversible injury of the cervical spinal cord in football players. J Bone Jt Surg Am 78:1308–1314

    CAS  Google Scholar 

  11. Gore DR (2001) Roentgenographic findings in the cervical spine in asymptomatic persons: a 10-year follow-up. Spine (Phila Pa 1976) 26:2463–2466

    Article  CAS  Google Scholar 

  12. Morishita Y, Naito M, Hymanson H, Miyazaki M, Wu G, Wang JC (2009) The relationship between the cervical spinal canal diameter and the pathological changes in the cervical spine. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 18:877–883. doi:10.1007/s00586-009-0968-y

    Article  Google Scholar 

  13. Shigematsu H, Ueda Y, Koizumi M, Takeshima T, Tanaka Y, Satoh N, Matsumori H, Oshima T, Matsuyama E, Kugai A, Takakura Y (2008) Does developmental canal stenosis influence surgical results of bilateral open-door laminoplasty for cervical spondylotic myelopathy? J Neurosurg Spine 9:358–362. doi:10.3171/spi.2008.9.10.358

    Article  PubMed  Google Scholar 

  14. Higo M (1987) Roentgenological study of anterior–posterior diameter in developmental canal stenosis of cervical spine. Nihon Seikeigeka Gakkai Zasshi 61:455–465

    CAS  PubMed  Google Scholar 

  15. Nagata K, Yoshimura N, Hashizume H, Muraki S, Ishimoto Y, Yamada H, Takiguchi N, Nakagawa Y, Minamide A, Oka H (2014) The prevalence of cervical myelopathy among subjects with narrow cervical spinal canal in a population-based magnetic resonance imaging study: the Wakayama Spine Study. Spine J 14:2811–2817

    Article  PubMed  Google Scholar 

  16. Yukawa Y, Kato F, Suda K, Yamagata M, Ueta T (2012) Age-related changes in osseous anatomy, alignment, and range of motion of the cervical spine. Part I: radiographic data from over 1200 asymptomatic subjects. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 21:1492–1498. doi:10.1007/s00586-012-2167-5

    Article  Google Scholar 

  17. Kato F, Yukawa Y, Suda K, Yamagata M, Ueta T (2012) Normal morphology, age-related changes and abnormal findings of the cervical spine. Part II: magnetic resonance imaging of over 1200 asymptomatic subjects. Eur Spine J Off Publ Eur Spine Soc Eur Spinal Deform Soc Eur Sect Cerv Spine Res Soc 21:1499–1507. doi:10.1007/s00586-012-2176-4

    Article  Google Scholar 

  18. Nakashima H, Yukawa Y, Suda K, Yamagata M, Ueta T, Kato F (2015) Abnormal findings on magnetic resonance images of the cervical spines in 1211 asymptomatic subjects. Spine 40:392–398

    Article  PubMed  Google Scholar 

  19. Yukawa Y, Kato F, Yoshihara H, Yanase M, Ito K (2007) MR T2 image classification in cervical compression myelopathy: predictor of surgical outcomes. Spine 32:1675–1678

    Article  PubMed  Google Scholar 

  20. Murone I (1974) The importance of the sagittal diameters of the cervical spinal canal in relation to spondylosis and myelopathy. J Bone Jt Surg Br 56:30–36

    CAS  Google Scholar 

  21. Higo M, Sakou T, Suzuki Y, Matsumoto R, Ito H, Kosakura H (1984) Roentogenologicalstudyoftheantero-posteriordiameter in cervical developmental canal stenosis [in Japanese]. Rinsho Seikei Geka 19:361–366

    Google Scholar 

  22. Goto S-I, Umehara J, Aizawa T, Kokubun S (2010) Comparison of cervical spinal canal diameter between younger and elder generations of Japanese. J Orthop Sci 15:97–103

    Article  PubMed  Google Scholar 

  23. Wolf BS, Khilnani M, Malis L (1956) The sagittal diameter of the bony cervical spinal canal and its significance in cervical spondylosis. J Mt Sinai Hosp N Y 23:283–292

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

This study was supported by institutional funds and by grant research funds, which are intended for promoting hospital functions, of the Japan Labor Health and Welfare Organization (Kawasaki, Japan).

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai, Shouwa-ku, Nagoya, Aichi, 466-8560, Japan

    Hiroaki Nakashima

  2. Department of Orthopedic Surgery, Chubu Rosai Hospital, Nagoya, Japan

    Yasutsugu Yukawa & Fumihiko Kato

  3. Department of Orthopedic Surgery, Hokkaido Chuo Rosai Hospital Sekison Center, Hokkaido, Japan

    Kota Suda

  4. Department of Orthopedic Surgery, Chiba Rosai Hospital, Nagoya, Japan

    Masatsune Yamagata

  5. Department of Orthopedic Surgery, Spinal Injuries Center, Iizuka, Japan

    Takayoshi Ueta

Authors
  1. Hiroaki Nakashima
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  2. Yasutsugu Yukawa
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  3. Kota Suda
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  4. Masatsune Yamagata
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  5. Takayoshi Ueta
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  6. Fumihiko Kato
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Correspondence to Hiroaki Nakashima.

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No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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Nakashima, H., Yukawa, Y., Suda, K. et al. Narrow cervical canal in 1211 asymptomatic healthy subjects: the relationship with spinal cord compression on MRI. Eur Spine J 25, 2149–2154 (2016). https://doi.org/10.1007/s00586-016-4608-z

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  • DOI: https://doi.org/10.1007/s00586-016-4608-z

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