Skip to main content

Advertisement

SpringerLink
Log in

Correlation between the severity of myelopathy and cervical morphometric parameters on dynamic magnetic resonance imaging

  • Original Article - Spine degenerative
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

To compare morphometric factors of cervical spine in the cervical stenosis on dynamic and static magnetic resonance imaging. To analyse the relationship between the severity of myelopathy and morphometric parameters.

Methods

Patients with cervical canal stenosis scanned with MRI in neutral (N), flexion (F) and extension (E) positions were retrospectively reviewed. All cases were evaluated in Nurick and Muhle grades. Following parameters were measured: anterior and posterior length of the cervical cord (aLCC, pLCC), mid-cord distance (L value), cervical cord angle (CCA), cervical lordosis, spine/cord (S/C) angle ratio, spinal cord (SC) area, cerebrospinal fluid (CSF) area, and CSF reserve ratio (CSF/CSF plus SC). Univariate multiple regression for Nurick grade as dependent factor was used.

Results

Sixty-three patients and 34 men, with the mean age of 58.2 ± 11 years, were analysed. Significant differences were found for pLCC, SC area, C lordosis and CCA. The difference between F and E for C lordosis angle was 42.80° ± 14.4 and for CC angle 30.42° ± 9.6. The mean S/C angle ratio was calculated for 1.4 ± 1.3. Nurick grade positively correlated with age (p = 0.041) and S/C angle ratio (p = 0.011), negatively with SC area (p = 0.006) and flexion-extension difference of L value (0.004).

Conclusions

Severity of myelopathy correlates with age, spinal cord area on extension and reduced mobility of spinal cord. An association between spine/cervical cord angle mismatch and Nurick grade was found.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Beattie MS, Manley GT (2011) Tight squeeze, slow burn: inflammation and the aetiology of cervical myelopathy. Brain J Neurol 134(Pt 5):1259–1261

    Article  Google Scholar 

  2. Breig A (1970) Overstretching of and circumscribed pathological tension in the spinal cord—a basic cause of symptoms in cord disorders. J Biomech 3(1):7–9

    Article  CAS  PubMed  Google Scholar 

  3. Breig A (1978) Adverse mechanical tension in the central nervous system. John Wiley & Sons Inc, New York

    Google Scholar 

  4. Dalbayrak S, Yaman O, Firidin MN, Yilmaz T, Yilmaz M (2015) The contribution of cervical dynamic magnetic resonance imaging to the surgical treatment of cervical spondylotic myelopathy. Turk Neurosurg 25(1):36–42

    PubMed  Google Scholar 

  5. Endo K, Suzuki H, Nishimura H, Tanaka H, Shishido T, Yamamoto K (2014) Kinematic analysis of the cervical cord and cervical canal by dynamic neck motion. Asian Spine J 8(6):747–752

    Article  PubMed  PubMed Central  Google Scholar 

  6. Guppy KH, Hawk M, Chakrabarti I, Banerjee A (2009) The use of flexion-extension magnetic resonance imaging for evaluating signal intensity changes of the cervical spinal cord. J Neurosurg Spine 10(4):366–373

    Article  PubMed  Google Scholar 

  7. Harada T, Tsuji Y, Mikami Y, Hatta Y, Sakamoto A, Ikeda T, Tamai K, Hase H, Kubo T (2010) The clinical usefulness of preoperative dynamic MRI to select decompression levels for cervical spondylotic myelopathy. Magn Reson Imaging 28(6):820–825

    Article  PubMed  Google Scholar 

  8. Henderson FC, Geddes JF, Vaccaro AR, Woodard E, Berry KJ, Benzel EC (2005) Stretch-associated injury in cervical spondylotic myelopathy: new concept and review. Neurosurgery 56(5):1101–1113-1113

    PubMed  Google Scholar 

  9. Iwasaki M, Yamamoto T, Miyauchi A, Amano K, Yonenobu K (2002) Cervical kyphosis: predictive factors for progression of kyphosis and myelopathy. Spine 27(13):1419–1425

    Article  PubMed  Google Scholar 

  10. Kadanka Z, Adamova B, Kerkovsky M, Kadanka Z, Dusek L, Jurova B, Vlckova E, Bednarik J (2017) Predictors of symptomatic myelopathy in degenerative cervical spinal cord compression. Brain Behav. https://doi.org/10.1002/brb3.797

  11. Kadanka Z, Kerkovsky M, Bednarik J, Jarkovsky J (2007) Cross-sectional transverse area and hyperintensities on magnetic resonance imaging in relation to the clinical picture in cervical spondylotic myelopathy. Spine 32(23):2573–2577

    Article  PubMed  Google Scholar 

  12. Kelly JC, Groarke PJ, Butler JS, Poynton AR, O’Byrne JM (2012) The natural history and clinical syndromes of degenerative cervical spondylosis. Adv Orthop 2012:393642

    Article  PubMed  Google Scholar 

  13. Kitahara Y, Iida H, Tachibana S (1995) Effect of spinal cord stretching due to head flexion on intramedullary pressure. Neurol Med Chir (Tokyo) 35(5):285–288

    Article  CAS  Google Scholar 

  14. Koschorek F, Jensen HP, Terwey B (1986) Dynamic studies of cervical spinal canal and spinal cord by magnetic resonance imaging. Acta Radiol Suppl 369:727–729

    CAS  PubMed  Google Scholar 

  15. Kuwazawa Y, Pope MH, Bashir W, Takahashi K, Smith FW (2006) The length of the cervical cord: effects of postural changes in healthy volunteers using positional magnetic resonance imaging. Spine 31(17):E579–E583

    Article  PubMed  Google Scholar 

  16. Mattei TA, Goulart CR, Milano JB, Dutra LPF, Fasset DR (2011) Cervical spondylotic myelopathy: pathophysiology, diagnosis, and surgical techniques. ISRN Neurol 2011:463729

    Article  PubMed  PubMed Central  Google Scholar 

  17. Miyata K, Marui T, Miura J, Yoshiya S, Fujii M, Kurosaka M, Doita M (2006) Kinetic analysis of the cervical spinal cord in patients after spinous process-splitting laminoplasty using a kinematic magnetic resonance imaging technique. Spine 31(19):E690–E697

    Article  PubMed  Google Scholar 

  18. Muhle C, Metzner J, Weinert D, Falliner A, Brinkmann G, Mehdorn MH, Heller M, Resnick D (1998) Classification system based on kinematic MR imaging in cervical spondylitic myelopathy. AJNR Am J Neuroradiol 19(9):1763–1771

    CAS  PubMed  Google Scholar 

  19. Muhle C, Metzner J, Weinert D, Schön R, Rautenberg E, Falliner A, Brinkmann G, Mehdorn HM, Heller M, Resnick D (1999) Kinematic MR imaging in surgical management of cervical disc disease, spondylosis and spondylotic myelopathy. Acta Radiol Stockh Swed 1987 40(2):146–153

  20. Mullin J, Shedid D, Benzel E (2011) Overview of cervical Spondylosis pathophysiology and biomechanics. WScJ 2:89–97

    Google Scholar 

  21. Nouri A, Tetreault L, Singh A, Karadimas SK, Fehlings MG (2015) Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis. Spine 40(12):E675–E693

    Article  PubMed  Google Scholar 

  22. Nurick S (1972) The pathogenesis of the spinal cord disorder associated with cervical spondylosis. Brain J Neurol 95(1):87–100

    Article  CAS  Google Scholar 

  23. Okada E, Matsumoto M, Ichihara D et al (2009) Aging of the cervical spine in healthy volunteers: a 10-year longitudinal magnetic resonance imaging study. Spine 34(7):706–712

    Article  PubMed  Google Scholar 

  24. Pang D, Wilberger JE (1982) Tethered cord syndrome in adults. J Neurosurg 57(1):32–47

    Article  CAS  PubMed  Google Scholar 

  25. Panjabi M, White A (1988) Biomechanics of nonacute cervical spinal cord trauma. Spine 13(7):838–842

    Article  CAS  PubMed  Google Scholar 

  26. Reid JD (1960) Effects of flexion-extension movements of the head and spine upon the spinal cord and nerve roots. J Neurol Neurosurg Psychiatry 23:214–221

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Swartz EE, Floyd RT, Cendoma M (2005) Cervical spine functional anatomy and the biomechanics of injury due to compressive loading. J Athl Train 40(3):155–161

    PubMed  PubMed Central  Google Scholar 

  28. Tachibana S, Kitahara Y, Iida H, Yada K (1994) Spinal cord intramedullary pressure. A possible factor in syrinx growth. Spine 19(19):2174–2178-2179

    Article  CAS  PubMed  Google Scholar 

  29. Takano M, Kawabata S, Komaki Y, Shibata S, Hikishima K, Toyama Y, Okano H, Nakamura M (2014) Inflammatory cascades mediate synapse elimination in spinal cord compression. J Neuroinflammation 11:40

    Article  PubMed  PubMed Central  Google Scholar 

  30. Wang C, Tian F, Zhou Y, He W, Cai Z (2016) The incidence of cervical spondylosis decreases with aging in the elderly, and increases with aging in the young and adult population: a hospital-based clinical analysis. Clin Interv Aging 11:47–53

    PubMed  PubMed Central  Google Scholar 

  31. Xu N, Wang S, Yuan H, Liu X, Liu Z (2017) Does dynamic supine magnetic resonance imaging improve the diagnostic accuracy of cervical spondylotic myelopathy? A review of the current evidence. World Neurosurg 100:474–479

    Article  PubMed  Google Scholar 

  32. Zeitoun D, El Hajj F, Sariali E, Catonné Y, Pascal-Moussellard H (2015) Evaluation of spinal cord compression and hyperintense intramedullary lesions on T2-weighted sequences in patients with cervical spondylotic myelopathy using flexion-extension MRI protocol. Spine J Off J North Am Spine Soc 15(4):668–674

    Article  Google Scholar 

  33. Zhang L, Zeitoun D, Rangel A, Lazennec JY, Catonné Y, Pascal-Moussellard H (2011) Preoperative evaluation of the cervical spondylotic myelopathy with flexion-extension magnetic resonance imaging: about a prospective study of fifty patients. Spine 36(17):E1134–E1139

    Article  PubMed  Google Scholar 

Download references

Funding

No funding was received for this research.

Author information

Authors and Affiliations

  1. Department of Musculoskeletal, Spinal Unit, Royal Victoria Infirmary, Queen Victoria Rd, Newcastle upon Tyne, NE1 4LP, UK

    Tomasz Tykocki & Guy Wynne-Jones

  2. Department of Neuroradiology, Royal Victoria Infirmary, Newcastle upon Tyne, UK

    Johannes du Plessis

Authors
  1. Tomasz Tykocki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Johannes du Plessis
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Guy Wynne-Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tomasz Tykocki.

Ethics declarations

Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

For this type of study, formal consent is not required.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tykocki, T., du Plessis, J. & Wynne-Jones, G. Correlation between the severity of myelopathy and cervical morphometric parameters on dynamic magnetic resonance imaging. Acta Neurochir 160, 1251–1258 (2018). https://doi.org/10.1007/s00701-018-3540-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-018-3540-x

Keywords

Search

Navigation