Predictors of symptomatic myelopathy in degenerative cervical spinal cord compression

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...

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Bibliographic Details
Published in:Brain and behavior 2017-09, Vol.7 (9), p.e00797-n/a
Main Authors: Kadanka, Zdenek, Adamova, Blanka, Kerkovsky, Milos, Dusek, Ladislav, Jurova, Barbora, Vlckova, Eva, Bednarik, Josef
Format: Article
Language:English
Subjects:
Adult
Aged
cervical radiculopathy
Cervical Vertebrae - diagnostic imaging
Cervical Vertebrae - physiopathology
degenerative cervical myelopathy
Diffusion Tensor Imaging
Disease Progression
Female
Follow-Up Studies
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Multivariate analysis
nonmyelopathic degenerative cervical cord compression
Original Research
Physical Examination
predictive model
Prospective Studies
Spinal Cord Compression - diagnosis
Spinal Cord Compression - diagnostic imaging
Spinal Cord Compression - physiopathology
Spinal Cord Diseases - diagnosis
Spinal Cord Diseases - diagnostic imaging
Spinal Cord Diseases - physiopathology
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Summary: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. A prospective observational follow‐up study was performed in a cohort of 112 consecutive nonmyelopathic degenerative cervical cord compression 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). Radiculopathy, cross‐sectional spinal cord area 
ISSN:2162-3279
2162-3279
DOI:10.1002/brb3.797