Association Between Paraspinal Muscle Morphology, Clinical Symptoms, and Functional Status in Patients With Degenerative Cervical Myelopathy

Spine ◽  
2017 ◽  
Vol 42 (4) ◽  
pp. 232-239 ◽  
Author(s):  
Maryse Fortin ◽  
Octavian Dobrescu ◽  
Matthew Courtemanche ◽  
Carolyn J. Sparrey ◽  
Carlo Santaguida ◽  
...  
Keyword(s):  
Functional Status ◽  
Cervical Myelopathy ◽  
Clinical Symptoms ◽  
Paraspinal Muscle ◽  
Muscle Morphology ◽  
Degenerative Cervical Myelopathy

Association between Paraspinal Muscle Morphology, Clinical Symptoms and Functional Status in Patients with Degenerative Cervical Myelopathy

2016 ◽  
Vol 16 (10) ◽  
pp. S200 ◽  
Author(s):  
Maryse Fortin ◽  
Octavian Dobrescu ◽  
Matthew Courtemanche ◽  
Carolyn Sparrey ◽  
Carlo Santaguida ◽  
...  
Keyword(s):  
Functional Status ◽  
Cervical Myelopathy ◽  
Clinical Symptoms ◽  
Paraspinal Muscle ◽  
Muscle Morphology ◽  
Degenerative Cervical Myelopathy

The effect of ageing on presentation, management and outcomes in degenerative cervical myelopathy: a systematic review

2020 ◽  
Author(s):  
Ben Grodzinski ◽  
Rory Durham ◽  
Oliver Mowforth ◽  
Daniel Stubbs ◽  
Mark R N Kotter ◽  
...  
Keyword(s):  
Systematic Review ◽  
Functional Status ◽  
Cervical Myelopathy ◽  
Older Patients ◽  
Meta Analysis ◽  
Current Evidence ◽  
Clinical Aspects ◽  
Similar Amount ◽  
Degenerative Cervical Myelopathy ◽  
The Impact

Abstract Objective Degenerative cervical myelopathy (DCM) is a disabling neurological condition. The underlying degenerative changes are known to be more common with age, but the impact of age on clinical aspects of DCM has never been synthesised. The objective of this study is to determine whether age is a significant predictor in three domains—clinical presentation, surgical management and post-operative outcomes of DCM. Methods a systematic review of the Medline and Embase databases (inception to 12 December 2019), registered with PROSPERO (CRD42019162077) and reported in accordance with preferred reporting items of systematic reviews and meta-analysis (PRISMA) guidelines, was conducted. The inclusion criteria were full text articles in English, evaluating the impact of age on clinical aspects of DCM. Results the initial search yielded 2,420 citations, of which 206 articles were eventually included. Age was found to be a significant predictor in a variety of measures. Within the presentation domain, older patients have a worse pre-operative functional status. Within the management domain, older patients are more likely to undergo posterior surgery, with more levels decompressed. Within the outcomes domain, older patients have a worse post-operative functional status, but a similar amount of improvement in functional status. Because of heterogenous data reporting, meta-analysis was not possible. Conclusion the current evidence demonstrates that age significantly influences the presentation, management and outcomes of DCM. Although older patients have worse health at all individual timepoints, they experience the same absolute benefit from surgery as younger patients. This finding is of particular relevance when considering the eligibility of older patients for surgery.

scholarly journals Sex-Dependent Cortical Volume Changes in Patients with Degenerative Cervical Myelopathy

2021 ◽  
Vol 10 (17) ◽  
pp. 3965
Author(s):  
Talia C. Oughourlian ◽  
Chencai Wang ◽  
Noriko Salamon ◽  
Langston T. Holly ◽  
Benjamin M. Ellingson
Keyword(s):  
Cervical Myelopathy ◽  
Clinical Symptoms ◽  
Gray Matter Volume ◽  
Brain Regions ◽  
Cortical Volume ◽  
Female Patients ◽  
Asymptomatic Patients ◽  
Compensation Mechanisms ◽  
Male Patients ◽  
Degenerative Cervical Myelopathy

Degenerative cervical myelopathy (DCM) is a progressive condition characterized by degeneration of osseocartilaginous structures within the cervical spine resulting in compression of the spinal cord and presentation of clinical symptoms. Compared to healthy controls (HCs), studies have shown DCM patients experience structural and functional reorganization in the brain; however, sex-dependent cortical differences in DCM patients remains largely unexplored. In the present study, we investigate the role of sex differences on the structure of the cerebral cortex in DCM and determine how structural differences may relate to clinical measures of neurological function. T1-weighted structural MRI scans were acquired in 85 symptomatic and asymptomatic patients with DCM and 90 age-matched HCs. Modified Japanese Orthopedic Association (mJOA) scores were obtained for patients. A general linear model was used to determine vertex-level significant differences in gray matter volume (GMV) between the following groups (1) male HCs and female HCs, (2) male patients and female patients, (3) male patients and male HCs, and (4) female patients and female HCs. Within patients, males exhibited larger GMV in motor, language, and vision related brain regions compared to female DCM patients. Males demonstrated a significant positive correlation between GMV and mJOA score, in which patients with worsening neurological symptoms exhibited decreasing GMV primarily across somatosensory and motor related cortical regions. Females exhibited a similar association, albeit across a broader range of cortical areas including those involved in pain processing. In sensorimotor regions, female patients consistently showed smaller GMV compared with male patients, independent of mJOA score. Results from the current study suggest strong sex-related differences in cortical volume in patients with DCM, which may reflect hormonal influence or differing compensation mechanisms.

scholarly journals Is microdiffusion imaging able to improve the detection of cervical myelopathy? Study protocol of a prospective observational trial (MIDICAM-Trial)

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e029153
Author(s):  
Marc Hohenhaus ◽  
Karl Egger ◽  
Jan-Helge Klingler ◽  
Ulrich Hubbe ◽  
Marco Reisert ◽  
...  
Keyword(s):  
Study Protocol ◽  
Cervical Myelopathy ◽  
Clinical Symptoms ◽  
Negative Control ◽  
Observational Trial ◽  
Conventional Mri ◽  
Diffusion Parameters ◽  
Registration Number ◽  
Degenerative Cervical Myelopathy ◽  
Tissue Alterations

IntroductionThe diagnosis of degenerative cervical myelopathy (DCM) is difficult in numerous patients due to the limited correlation of clinical symptoms, electrophysiology and MRI. This applies especially for early disease stages with mild symptoms or in uncertainty due to comorbidities. Conventional MRI myelopathy signs show a restricted sensitivity to clinical symptoms of at most 60%. It is desirable to select patients for surgical treatment as early as possible before irreversible neurological damage occurs. To improve treatment, a more reliable imaging is necessary. Microdiffusion imaging (MIDI) is an innovative MRI modality to depict tissue alterations within one voxel based on diffusion-weighted imaging (DWI) postprocessing. By separating the affected area into several mesoscopic compartments, pathological changes might be detected more sensitive through this subtle tissue resolution. We hypothesise, that MIDI shows myelopathic alterations more sensitive than conventional MRI and improves the correlation to functional impairment.Methods and analysisIn this prospective, observational trial, 130 patients with a relevant degenerative cervical spinal stenosis receive MRI including MIDI and a standard clinical and electrophysiological assessment. Special subvoxel diffusion parameters are calculated. Clinical follow-ups are conducted after 3, 6 and with additional MRI and electrophysiology after 12 months. The primary endpoint is the sensitivity of MIDI to detect functional myelopathy defined by clinical and electrophysiological features correlated to conventional MRI myelopathy signs. Twenty healthy subjects will be included as negative control. The results will provide new insights into the development of mesoscopic spinal cord alterations in DCM associated to the clinical course. Aim is to improve the diagnostics of incipient myelopathy through this new modality.Ethics and disseminationThe study protocol is approved by the Ethics Committee of the University of Freiburg (reference 261/17). The results will be published in a peer-reviewed journal.Trial registration numberDRKS00012962.

scholarly journals Management of degenerative cervical myelopathy – An update

2016 ◽  
Vol 62 (9) ◽  
pp. 886-894 ◽  
Author(s):  
ANDREI F. JOAQUIM ◽  
ENRICO GHIZONI ◽  
HELDER TEDESCHI ◽  
WELLINGTON K. HSU ◽  
ALPESH A. PATEL
Keyword(s):  
Spinal Cord ◽  
Cervical Myelopathy ◽  
Clinical Symptoms ◽  
Surgical Techniques ◽  
The Other ◽  
Surgical Approaches ◽  
Japanese Orthopedic Association ◽  
Advantages And Disadvantages ◽  
Clinical Magnetic Resonance Imaging ◽  
Degenerative Cervical Myelopathy

SUMMARY Introduction Degenerative cervical myelopathy (DCM) is the most common cause of spinal cord dysfunction in adult patients. Patients generally present with a slow, progressive neurological decline or a stepwise deterioration pattern. In this paper, we discuss the most important factors involved in the management of DCM, including a discussion about the surgical approaches. Method The authors performed an extensive review of the peer-reviewed literature addressing the aforementioned objectives. Results Although the diagnosis is clinical, magnetic resonance imaging (MRI) is the study of choice to confirm stenosis and also to exclude the differential diagnosis. The severity the clinical symptoms of DCM are evaluated by different scales, but the modified Japanese Orthopedic Association (mJOA) and the Nürick scale are probably the most commonly used. Spontaneous clinical improvement is rare and surgery is the main treatment form in an attempt to prevent further neurological deterioration and, potentially, to provide some improvement in symptoms and function. Anterior, posterior or combined cervical approaches are used to decompress the spinal cord, with adjunctive fusion being commonly performed. The choice of one approach over the other depends on patient characteristics (such as number of involved levels, site of compression, cervical alignment, previous surgeries, bone quality, presence of instability, among others) as well as surgeon preference and experience. Conclusion Spine surgeons must understand the advantages and disadvantages of all surgical techniques to choose the best procedure for their patients. Further comparative studies are necessary to establish the superiority of one approach over the other when multiple options are available.

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