Abstract
Purpose
The aim of this prospective cross-sectional observational comparative study was to determine the prevalence of spondylotic cervical cord compression (SCCC) and symptomatic cervical spondylotic myelopathy (CSM) in patients with symptomatic lumbar spinal stenosis (LSS) in comparison with a general population sample and to seek to identify predictors for the development of CSM.
Methods
A group of 78 patients with LSS (48 men, median age 66 years) was compared with a randomly selected age- and sex-matched group of 78 volunteers (38 men, median age 66 years). We evaluated magnetic resonance imaging findings from the cervical spine and neurological examination.
Results
The presence of SCCC was demonstrated in 84.6 % of patients with LSS, but also in 57.7 % of a sample of volunteers randomly recruited from the general population. Clinically symptomatic CSM was found in 16.7 % of LSS patients in comparison with 1.3 % of volunteers (p = 0.001). Multivariable logistic regression proposed the Oswestry Disability Index of 43 % or more as the only independent predictor of symptomatic CSM in LSS patients (OR 9.41, p = 0.008).
Conclusions
The presence of symptomatic LSS increases the risk of SCCC; the prevalence of SCCC is higher in patients with symptomatic LSS in comparison with the general population, with an evident predominance of more serious types of MRI-detected compression and a clinically symptomatic form (CSM). Symptomatic CSM is more likely in LSS patients with higher disability as assessed by the Oswestry Disability Index.
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Abbreviations
- ASCCC:
-
Asymptomatic spondylotic cervical cord compression
- CSM:
-
Cervical spondylotic myelopathy
- CSR:
-
Cervical spondylotic radiculopathy
- LSS:
-
Lumbar spinal stenosis
- MRI:
-
Magnetic resonance imaging
- ODI:
-
Oswestry Disability Index
- OR:
-
Odds ratio
- ROC:
-
Receiver operating characteristic
- SCCC:
-
Spondylotic cervical cord compression
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Acknowledgments
This study was supported by Grant project NT-13449-4 of the Internal Grant Agency of the Ministry of Health of the Czech Republic and by Ministry of Health, Czech Republic-conceptual development of research organization (FNBr, 65269705).
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Adamova, B., Bednarik, J., Andrasinova, T. et al. Does lumbar spinal stenosis increase the risk of spondylotic cervical spinal cord compression?. Eur Spine J 24, 2946–2953 (2015). https://doi.org/10.1007/s00586-015-4049-0
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DOI: https://doi.org/10.1007/s00586-015-4049-0