The relationship between central motor conduction time and spinal cord compression in patients with cervical spondylotic myelopathy

Purpose:To assess the extent of demyelination in cervical spondylotic myelopathy (CSM) using myelin water imaging (MWI) and electrophysiologic techniques.Methods:Somatosensory evoked potentials (SSEPs) and MWI were acquired in 14 patients with CSM and 18 age-matched healthy controls. MWI was performed on a 3.0T whole body magnetic resonance scanner. Myelin water fraction (MWF) was extracted for the dorsal columns and whole cord. SSEPs and MWF were also compared with conventional MRI outcomes, including T2 signal intensity, compression ratio, maximum spinal cord compression (MSCC), and maximum canal compromise (MCC).Results:Group analysis showed marked differences in T2 signal intensity, compression ratio, MSCC, and MCC between healthy controls and patients with CSM. There were no group differences in MWF and SSEP latencies. However, patients with CSM with pathologic SSEPs exhibited reduction in MWF (p < 0.05). MWF was also correlated with SSEP latencies.Conclusion:Our findings provide evidence of decreased myelin content in the spinal cord associated with impaired spinal cord conduction in patients with CSM. While conventional MRI are of great value to define the extent of cord compression, they show a limited correlation with functional deficits (i.e., delayed SSEPs). MWI provides independent and complementary readouts to spinal cord compression, with a high specificity to detect impaired conduction.

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Predictive Effect of Cervical Spinal Cord Compression and Corresponding Segmental Paravertebral Muscle Degeneration on the Severity of Symptoms in Patients with Cervical Spondylotic Myelopathy

The Spine Journal ◽

10.1016/j.spinee.2021.03.030 ◽

2021 ◽

Author(s):

Taotao Lin ◽

Zhenyu Wang ◽

Gang Chen ◽

Wenge Liu

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Cervical Spondylotic Myelopathy ◽

Cervical Spinal Cord ◽

Cord Compression ◽

Muscle Degeneration ◽

Paravertebral Muscle ◽

Predictive Effect

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Epidemiological study of cervical cord compression and its clinical symptoms in community-dwelling residents

PLoS ONE ◽

10.1371/journal.pone.0256732 ◽

2021 ◽

Vol 16 (8) ◽

pp. e0256732

Author(s):

Toru Hirai ◽

Koji Otani ◽

Miho Sekiguchi ◽

Shin-ichi Kikuchi ◽

Shin-ichi Konno

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Clinical Symptoms ◽

Cord Compression ◽

Community Dwelling ◽

Gait Disturbance ◽

Cervical Cord ◽

Cervical Cord Compression ◽

The Relationship ◽

Disc Level

Background Degenerative compressive myelopathy (DCM) is caused by cervical cord compression. The relationship between the magnitude and clinical findings of cervical cord compression has been described in the literature, but the details remain unclear. This study aimed to clarify the relationship between the magnitude and clinical symptoms of cervical cord compression in community-dwelling residents. Methods The present study included 532 subjects. The subjective symptoms and the objective findings of one board-certified spine surgeon were assessed. The subjective symptoms were upper extremity pain and numbness, clumsy hand, fall in the past 1 year, and subjective gait disturbance. The objective findings were: Hoffmann, Trömner, and Wartenberg signs; Babinski’s and Chaddock’s signs; hyperreflexia of the patellar tendon and Achilles tendon reflexes; ankle clonus; Romberg and modified Romberg tests; grip and release test; finger escape sign; and grip strength. Using midsagittal T2-weighted magnetic resonance imaging, the anterior–posterior (AP) diameters (mm) of the spinal cord at the C2 midvertebral body level (DC2) and at each intervertebral disc level from C2/3 to C7/T1 (DC2/3-C7/T1) were measured. The spinal cord compression ratio (R) for each intervertebral disc level was defined and calculated as DC2/3-C7/T1 divided by DC2. The lowest R (LR) along C2/3 to C7/T1 of each individual was divided into 3 grades by the tertile method. The relationship between LR and clinical symptoms was investigated by trend analysis. Results The prevalence of subjective gait disturbance increased significantly with the severity of spinal cord compression (p = 0.002812), whereas the other clinical symptoms were not significantly related with the severity of spinal cord compression. Conclusions The magnitude of cervical cord compression had no relationship with any of the neurologic findings. However, subjective gait disturbance might be a better indicator of the possibility of early stage cervical cord compression.

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12. Angiotensin-II type-1 receptor blockade decreased T2 signal intensity in spinal cord compression in symptomatic cervical spondylotic myelopathy

The Spine Journal ◽

10.1016/j.spinee.2019.05.025 ◽

2019 ◽

Vol 19 (9) ◽

pp. S6

Author(s):

Alexander Perdomo-Pantoja ◽

Alejandro Chara ◽

Joshua Casaos ◽

Samuel Kalb ◽

Corinna Zygourakis ◽

...

Keyword(s):

Spinal Cord ◽

Angiotensin Ii ◽

Spinal Cord Compression ◽

Signal Intensity ◽

Cervical Spondylotic Myelopathy ◽

Cord Compression ◽

Receptor Blockade

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The value of decompression for acute experimental spinal cord compression injury

Journal of Neurosurgery ◽

10.3171/jns.1980.53.6.0749 ◽

1980 ◽

Vol 53 (6) ◽

pp. 749-755 ◽

Cited By ~ 151

Author(s):

Eugen J. Dolan ◽

Charles H. Tator ◽

Laszlo Endrenyi

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Functional Recovery ◽

Cord Compression ◽

Compression Method ◽

Compression Injury ◽

Inclined Plane ◽

Content Type ◽

Plane Technique ◽

The Relationship

✓ A clip compression method was used to produce acute spinal cord compression injury in rats. The force and duration of the spinal cord compression were independently varied, and functional recovery of the cord was assessed using the inclined plane technique. Mathematical modeling produced a curve defining the relationship between force, duration, and functional recovery for each week after injury. The study clearly showed the beneficial effect of decompression and that increasing either the force or duration of compression, or both, caused a reduction in recovery.

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