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Lookup NU author(s): Tomasz Tykocki
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© 2018 Elsevier Inc. Objective: A dynamic compression injury of the cervical spinal cord (SC) is widely accepted in the pathophysiology of cervical myelopathy. Flexion/extension magnetic resonance imaging (MRI) provides information on the dynamic cervical injury. We sought to compare morphometric parameters on neutral and flexion/extension MRI in cervical spondylotic myelopathy. Methods: Patients with cervical canal stenosis who had MRI in neutral, flexion, and extension positions were reviewed retrospectively. A morphometric comparison of following parameters at compression level was performed: SC area, cerebrospinal fluid (CSF) area, and CSF reserve ratio (CSF/CSF plus SC). Patients were classified according to the presence of high signal (HS) in SC, and predictors of HS were calculated by the use of logistic regression analysis. Results: In total, 55 patients, 26 men, with mean age of 57 ± 13 were analyzed. Significant difference was found in mean CSF reserve ratio between flexion and extension (0.47 ± 0.18 vs. 0.40 ± 0.21, P < 0.05). SC area was significantly smaller in flexion (58.8 ± 13.3 mm2) than in both neutral (66.9 ± 22.3 mm2) and extension (68.3 ± 19.1 mm2). HS was found in 22 cases, and predictors of HS were smaller SC area on extension (odds ratio 1.46; 95% confidence interval 1.07–1.84) and smaller CSF plus SC area on flexion (OR 1.32; 95% confidence interval 1.06–1.45). Cut-off values on the receiver operating characteristic curve were 55 mm2 for SC and 99 mm2 for CSF plus SC area. Conclusions: Application of dynamic MRI in cervical stenosis reveals significant differences of both SC and CSF reserve ratio in flexion/extension and neutral positions. Patients with smaller SC area in extension and smaller CSF plus SC area in flexion have greater risk of HS on MRI.
Author(s): Tykocki T, du Plessis J, Wynne-Jones G
Publication type: Article
Publication status: Published
Journal: World Neurosurgery
Year: 2018
Volume: 114
Pages: e317-e322
Print publication date: 01/06/2018
Online publication date: 07/03/2018
Acceptance date: 26/02/2018
ISSN (print): 1878-8750
ISSN (electronic): 1878-8769
Publisher: Elsevier Inc.
URL: https://doi.org/10.1016/j.wneu.2018.02.179
DOI: 10.1016/j.wneu.2018.02.179
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