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Lookup NU author(s): Tomasz Tykocki
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© 2018 Elsevier Inc. Background: Cervical myelopathy is a complex pathology and dynamic compression of the tethered cervical cord, which may be responsible for clinical symptoms. Methods: Patients with cervical canal stenosis who had magnetic resonance imaging in flexion and extension positions were retrospectively reviewed. All cases were evaluated in Nurick grade. The cervical parameters—cervical cord (CC) angle, cervical lordosis, and spine/cord (S/C) angle ratio—were measured on the magnetic resonance imaging. Mean values of these parameters were compared between nonmyelopathic (Nurick grade 0) and myelopathic groups (Nurick grades 1–5). A multinomial ordinal logistic regression was used to predict outcome for Nurick grade using the CC angle, the cervical lordosis angle, and the S/C angle ratio as independent variables. Results: A total of 65 patients (35 men) with the mean age of 58.6 ± 11.4 years were analyzed. A comparison of means between Nurick grade 0 against each of myelopathic grades 1–5 revealed significant differences only for the S/C angle ratio. A cumulative comparison between nonmyelopathic and myelopathic grades for the S/C angle ratio showed significant difference of 0.29 (1.16 ± 0.5 vs. 1.45 ± 0.6, respectively; P < 0.05). Cumulative comparison for the CC angle difference in flexion and extension lordosis did not show substantial differences. The S/C angle ratio was the only significant parameter in the prediction of the Nurick grade with an odds ratio of 2.63 (95% confidence interval 2.11–2.79). Conclusions: A positive correlation between Nurick grade and cervical spine and cord angle mismatch was found.
Author(s): Tykocki T, du Plessis J, Wynne-Jones G
Publication type: Article
Publication status: Published
Journal: World Neurosurgery
Year: 2018
Volume: 115
Pages: e272-e278
Print publication date: 01/07/2018
Online publication date: 13/04/2018
Acceptance date: 05/04/2018
ISSN (print): 1878-8750
ISSN (electronic): 1878-8769
Publisher: Elsevier Inc.
URL: https://doi.org/10.1016/j.wneu.2018.04.033
DOI: 10.1016/j.wneu.2018.04.033
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