Predictors of symptomatic myelopathy in degenerative cervical spinal cord compression
Jazyk angličtina Země Spojené státy americké Médium electronic-ecollection
Typ dokumentu časopisecké články
PubMed
28948090
PubMed Central
PMC5607559
DOI
10.1002/brb3.797
PII: BRB3797
Knihovny.cz E-zdroje
- Klíčová slova
- cervical radiculopathy, degenerative cervical myelopathy, magnetic resonance imaging, nonmyelopathic degenerative cervical cord compression, predictive model,
- MeSH
- dospělí MeSH
- fyzikální vyšetření MeSH
- komprese míchy diagnóza diagnostické zobrazování patofyziologie MeSH
- krční obratle diagnostické zobrazování patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- magnetická rezonanční tomografie MeSH
- následné studie MeSH
- nemoci míchy diagnóza diagnostické zobrazování patofyziologie MeSH
- progrese nemoci MeSH
- prospektivní studie MeSH
- senioři MeSH
- zobrazování difuzních tenzorů MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: To update a previously established list of predictors for neurological cervical cord dysfunction in nonmyelopathic degenerative cervical cord compression (NMDCCC). MATERIAL AND METHODS: A prospective observational follow-up study was performed in a cohort of 112 consecutive NMDCCC subjects (55 women and 57 men; median age 59 years, range 40-79 years), either asymptomatic (40 subjects) or presenting with cervical radiculopathy or cervical pain (72 subjects), who had completed a follow-up of at least 2 years (median duration 3 years). Development of clinical signs of degenerative cervical myelopathy (DCM) as the main outcome was monitored and correlated with a large number of demographic, clinical, electrophysiological, and MRI parameters including diffusion tensor imaging characteristics (DTI) established at entry. RESULTS: Clinical evidence of the first signs and symptoms of DCM were found in 15 patients (13.4%). Development of DCM was associated with several parameters, including the clinical (radiculopathy, prolonged gait and run-time), electrophysiological (SEP, MEP and EMG signs of cervical cord dysfunction), and MRI (anteroposterior diameter of the cervical cord and cervical canal, cross-sectional area, compression ratio, type of compression, T2 hyperintensity). DTI parameters showed no significant predictive power. Multivariate analysis showed that radiculopathy, cross-sectional area (CSA) ≤ 70.1 mm2, and compression ratio (CR) ≤ 0.4 were the only independent significant predictors for progression into symptomatic myelopathy. CONCLUSIONS: In addition to previously described independent predictors of DCM development (radiculopathy and electrophysiological dysfunction of cervical cord), MRI parameters, namely CSA and CR, should also be considered as significant predictors for development of DCM.
Department of Neurology University Hospital Brno Brno Czech Republic
Department of Radiology University Hospital Brno Brno Czech Republic
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