Facet Articular Irregularity Is the Most Relevant Risk Factor for Rapidly Progressive Degenerative Cervical Myelopathy
Objective Facet articular irregularity is associated with rapidly progressive degenerative cervical myelopathy (DCM). However, its significance compared with other known risk factors remains unknown. Therefore, this retrospective study aimed to clarify the potential impact of facet articular irregul...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Spinal Neurosurgery Society
2023-03-01
|
| Series: | Neurospine |
| Subjects: | |
| Online Access: | http://e-neurospine.org/upload/pdf/ns-2245004-502.pdf |
| _version_ | 1797328451871440896 |
|---|---|
| author | Yasuhiro Takeshima Ai Okamoto Shohei Yokoyama Fumihiko Nishimura Ichiro Nakagawa Young-Soo Park Hiroyuki Nakase |
| author_facet | Yasuhiro Takeshima Ai Okamoto Shohei Yokoyama Fumihiko Nishimura Ichiro Nakagawa Young-Soo Park Hiroyuki Nakase |
| author_sort | Yasuhiro Takeshima |
| collection | DOAJ |
| description | Objective Facet articular irregularity is associated with rapidly progressive degenerative cervical myelopathy (DCM). However, its significance compared with other known risk factors remains unknown. Therefore, this retrospective study aimed to clarify the potential impact of facet articular irregularity as a risk factor for rapid DCM progression. Methods This study included 141 consecutive patients with DCM who underwent surgical treatment at our institution. Clinical variables and radiological findings related to DCM progression were collected. Imaging findings were analyzed at the segmental level of myelopathy in each case. The patients were divided into 2 groups based on the presence or absence of rapid DCM progression, and independent risk factors were determined using logistic regression analyses. Results Overall, 131 patients with a mean age of 63.9±12.6 years were analyzed; 27 patients (20.6%) were classified into the rapid DCM progression group. The mean age was significantly higher in the rapid progression group than in the slow progression group (72.4±9.6 vs. 61.7±12.4, p<0.001). According to univariate analysis, facet articular irregularity, dynamic segmental translation (≥1.6 mm), upper cervical spine involvement above C4–5, history of cerebrovascular events, preceding minor trauma, local lordotic angle (≥4.5°), diabetes, hypertension, ligamentum flavum hypertrophy, and age were independent risk factors. Additionally, multivariate analysis showed that facet articular irregularity was the highest risk factor for rapid DCM progression (p=0.001). Conclusion Facet articular irregularity is the most clinically significant finding among the known risk factors in patients with rapid DCM progression. |
| first_indexed | 2024-03-08T06:52:00Z |
| format | Article |
| id | doaj.art-5909dd5af7ce4ed69a546ce4acc48641 |
| institution | Directory Open Access Journal |
| issn | 2586-6583 2586-6591 |
| language | English |
| last_indexed | 2024-03-08T06:52:00Z |
| publishDate | 2023-03-01 |
| publisher | Korean Spinal Neurosurgery Society |
| record_format | Article |
| series | Neurospine |
| spelling | doaj.art-5909dd5af7ce4ed69a546ce4acc486412024-02-03T06:43:45ZengKorean Spinal Neurosurgery SocietyNeurospine2586-65832586-65912023-03-0120136537310.14245/ns.2245004.5021368Facet Articular Irregularity Is the Most Relevant Risk Factor for Rapidly Progressive Degenerative Cervical MyelopathyYasuhiro Takeshima0Ai Okamoto1Shohei Yokoyama2Fumihiko Nishimura3Ichiro Nakagawa4Young-Soo Park5Hiroyuki Nakase6 Department of Neurosurgery, Nara Medical University School of Medicine, Kashihara, Japan Department of Neurosurgery, Nara Medical University School of Medicine, Kashihara, Japan Department of Neurosurgery, Nara Medical University School of Medicine, Kashihara, Japan Department of Neurosurgery, Nara Medical University School of Medicine, Kashihara, Japan Department of Neurosurgery, Nara Medical University School of Medicine, Kashihara, Japan Department of Neurosurgery, Nara Medical University School of Medicine, Kashihara, Japan Department of Neurosurgery, Nara Medical University School of Medicine, Kashihara, JapanObjective Facet articular irregularity is associated with rapidly progressive degenerative cervical myelopathy (DCM). However, its significance compared with other known risk factors remains unknown. Therefore, this retrospective study aimed to clarify the potential impact of facet articular irregularity as a risk factor for rapid DCM progression. Methods This study included 141 consecutive patients with DCM who underwent surgical treatment at our institution. Clinical variables and radiological findings related to DCM progression were collected. Imaging findings were analyzed at the segmental level of myelopathy in each case. The patients were divided into 2 groups based on the presence or absence of rapid DCM progression, and independent risk factors were determined using logistic regression analyses. Results Overall, 131 patients with a mean age of 63.9±12.6 years were analyzed; 27 patients (20.6%) were classified into the rapid DCM progression group. The mean age was significantly higher in the rapid progression group than in the slow progression group (72.4±9.6 vs. 61.7±12.4, p<0.001). According to univariate analysis, facet articular irregularity, dynamic segmental translation (≥1.6 mm), upper cervical spine involvement above C4–5, history of cerebrovascular events, preceding minor trauma, local lordotic angle (≥4.5°), diabetes, hypertension, ligamentum flavum hypertrophy, and age were independent risk factors. Additionally, multivariate analysis showed that facet articular irregularity was the highest risk factor for rapid DCM progression (p=0.001). Conclusion Facet articular irregularity is the most clinically significant finding among the known risk factors in patients with rapid DCM progression.http://e-neurospine.org/upload/pdf/ns-2245004-502.pdfarticularcervical myelopathydegenerativefacet jointlogistic regressionrisk factor |
| spellingShingle | Yasuhiro Takeshima Ai Okamoto Shohei Yokoyama Fumihiko Nishimura Ichiro Nakagawa Young-Soo Park Hiroyuki Nakase Facet Articular Irregularity Is the Most Relevant Risk Factor for Rapidly Progressive Degenerative Cervical Myelopathy Neurospine articular cervical myelopathy degenerative facet joint logistic regression risk factor |
| title | Facet Articular Irregularity Is the Most Relevant Risk Factor for Rapidly Progressive Degenerative Cervical Myelopathy |
| title_full | Facet Articular Irregularity Is the Most Relevant Risk Factor for Rapidly Progressive Degenerative Cervical Myelopathy |
| title_fullStr | Facet Articular Irregularity Is the Most Relevant Risk Factor for Rapidly Progressive Degenerative Cervical Myelopathy |
| title_full_unstemmed | Facet Articular Irregularity Is the Most Relevant Risk Factor for Rapidly Progressive Degenerative Cervical Myelopathy |
| title_short | Facet Articular Irregularity Is the Most Relevant Risk Factor for Rapidly Progressive Degenerative Cervical Myelopathy |
| title_sort | facet articular irregularity is the most relevant risk factor for rapidly progressive degenerative cervical myelopathy |
| topic | articular cervical myelopathy degenerative facet joint logistic regression risk factor |
| url | http://e-neurospine.org/upload/pdf/ns-2245004-502.pdf |
| work_keys_str_mv | AT yasuhirotakeshima facetarticularirregularityisthemostrelevantriskfactorforrapidlyprogressivedegenerativecervicalmyelopathy AT aiokamoto facetarticularirregularityisthemostrelevantriskfactorforrapidlyprogressivedegenerativecervicalmyelopathy AT shoheiyokoyama facetarticularirregularityisthemostrelevantriskfactorforrapidlyprogressivedegenerativecervicalmyelopathy AT fumihikonishimura facetarticularirregularityisthemostrelevantriskfactorforrapidlyprogressivedegenerativecervicalmyelopathy AT ichironakagawa facetarticularirregularityisthemostrelevantriskfactorforrapidlyprogressivedegenerativecervicalmyelopathy AT youngsoopark facetarticularirregularityisthemostrelevantriskfactorforrapidlyprogressivedegenerativecervicalmyelopathy AT hiroyukinakase facetarticularirregularityisthemostrelevantriskfactorforrapidlyprogressivedegenerativecervicalmyelopathy |