Spinal Cord Motion in Degenerative Cervical Myelopathy: The Level of the Stenotic Segment and Gender Cause Altered Pathodynamics

In degenerative cervical myelopathy (DCM), focally increased spinal cord motion has been observed for C5/C6, but whether stenoses at other cervical segments lead to similar pathodynamics and how severity of stenosis, age, and gender affect them is still unclear. We report a prospective matched-pair...

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Bibliographic Details
Main Authors: Katharina Wolf, Marco Reisert, Saúl Felipe Beltrán, Jan-Helge Klingler, Ulrich Hubbe, Axel J. Krafft, Nico Kremers, Karl Egger, Marc Hohenhaus
Format: Article
Language:English
Published: MDPI AG 2021-08-01
Series:Journal of Clinical Medicine
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Online Access:https://www.mdpi.com/2077-0383/10/17/3788
Description
Summary:In degenerative cervical myelopathy (DCM), focally increased spinal cord motion has been observed for C5/C6, but whether stenoses at other cervical segments lead to similar pathodynamics and how severity of stenosis, age, and gender affect them is still unclear. We report a prospective matched-pair controlled trial on 65 DCM patients. A high-resolution 3D T2 sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) and a phase-contrast magnetic resonance imaging (MRI) sequence were performed and automatically segmented. Anatomical and spinal cord motion data were assessed per segment from C2/C3 to C7/T1. Spinal cord motion was focally increased at a level of stenosis among patients with stenosis at C4/C5 (<i>n</i> = 14), C5/C6 (<i>n</i> = 33), and C6/C7 (<i>n</i> = 10) (<i>p</i> < 0.033). Patients with stenosis at C2/C3 (<i>n</i> = 2) and C3/C4 (<i>n</i> = 6) presented a similar pattern, not reaching significance. Gender was a significant predictor of higher spinal cord dynamics among men with stenosis at C5/C6 (<i>p</i> = 0.048) and C6/C7 (<i>p</i> = 0.033). Age and severity of stenosis did not relate to spinal cord motion. Thus, the data demonstrates focally increased spinal cord motion depending on the specific level of stenosis. Gender-related effects lead to dynamic alterations among men with stenosis at C5/C6 and C6/C7. The missing relation of motion to severity of stenosis underlines a possible additive diagnostic value of spinal cord motion analysis in DCM.
ISSN:2077-0383