Spinal cord swelling in patients with cervical compression myelopathy.
Adult
Aged
Aged, 80 and over
Cervical Vertebrae
Edema
/ diagnosis
Female
Humans
Laminectomy
Magnetic Resonance Imaging
Male
Middle Aged
Prognosis
Retrospective Studies
Sex Factors
Spinal Cord
/ diagnostic imaging
Spinal Cord Compression
/ diagnosis
Spondylosis
/ complications
Time Factors
Time-to-Treatment
Treatment Outcome
Cervical spondylosis
Early-onset
Intramedullary hyperintense lesion
Rapid disease progression
Spinal cord edema
Journal
BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565
Informations de publication
Date de publication:
14 Jun 2019
14 Jun 2019
Historique:
received:
22
12
2018
accepted:
10
06
2019
entrez:
16
6
2019
pubmed:
16
6
2019
medline:
18
12
2019
Statut:
epublish
Résumé
Intramedullary hyperintense lesions associated with spinal cord edema on T2-weighted MR images (T2WI) are rare findings in patients with cervical spondylosis and are poorly characterized. We investigated the clinical characteristics of spinal cord edema due to cervical spondylosis (SCECS). In total, 214 patients with cervical spondylotic myelopathy who underwent surgery between April 2007 and March 2017 were divided into SCECS and non-SCECS groups with SCECS defined as follows: (1) intramedullary signal intensity (ISI) of the cervical spinal cord in sagittal T2WI extending to more than one vertebral body height; (2) "fuzzy" ISI, recognized as a faint intramedullary change with a largely indistinct and hazy border; and (3) a larger sagittal diameter of the spinal cord segment with ISI just above or below the cord compression area compared with areas of the cervical spine without ISI. Radiographic parameters, demographic characteristics, and the Japanese Orthopedic Association (JOA) surgical outcomes score were compared between the groups. Seventeen patients (7.9%) were diagnosed with SCECS. These patients were younger than those in the non-SCECS group [median (interquartile range), 64 (20) vs. 69 (15) years, respectively, p = 0.016], and the disease duration from onset to surgery was significantly shorter in the SCECS group than in the non-SCECS group [6 (7) vs. 20 (48) months, respectively]. No significant difference was observed between groups with respect to sex, radiologic findings, or surgical outcomes. The disease showed an earlier onset and more rapid progression in the patients with SCECS than in those without SCECS.
Sections du résumé
BACKGROUND
BACKGROUND
Intramedullary hyperintense lesions associated with spinal cord edema on T2-weighted MR images (T2WI) are rare findings in patients with cervical spondylosis and are poorly characterized. We investigated the clinical characteristics of spinal cord edema due to cervical spondylosis (SCECS).
METHODS
METHODS
In total, 214 patients with cervical spondylotic myelopathy who underwent surgery between April 2007 and March 2017 were divided into SCECS and non-SCECS groups with SCECS defined as follows: (1) intramedullary signal intensity (ISI) of the cervical spinal cord in sagittal T2WI extending to more than one vertebral body height; (2) "fuzzy" ISI, recognized as a faint intramedullary change with a largely indistinct and hazy border; and (3) a larger sagittal diameter of the spinal cord segment with ISI just above or below the cord compression area compared with areas of the cervical spine without ISI. Radiographic parameters, demographic characteristics, and the Japanese Orthopedic Association (JOA) surgical outcomes score were compared between the groups.
RESULTS
RESULTS
Seventeen patients (7.9%) were diagnosed with SCECS. These patients were younger than those in the non-SCECS group [median (interquartile range), 64 (20) vs. 69 (15) years, respectively, p = 0.016], and the disease duration from onset to surgery was significantly shorter in the SCECS group than in the non-SCECS group [6 (7) vs. 20 (48) months, respectively]. No significant difference was observed between groups with respect to sex, radiologic findings, or surgical outcomes.
CONCLUSION
CONCLUSIONS
The disease showed an earlier onset and more rapid progression in the patients with SCECS than in those without SCECS.
Identifiants
pubmed: 31200693
doi: 10.1186/s12891-019-2673-2
pii: 10.1186/s12891-019-2673-2
pmc: PMC6570955
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
284Références
Neurosurgery. 2001 Jan;48(1):174-85; discussion 185-6
pubmed: 11152344
Neurosurgery. 2001 Mar;48(3):636-45; discussion 645-6
pubmed: 11270555
Clin Orthop Relat Res. 1975;(109):85-96
pubmed: 1132209
Neurosurgery. 2003 Apr;52(4):806-15; discussion 815-6
pubmed: 12657176
J Neurosurg. 2003 Jul;99(1 Suppl):8-13
pubmed: 12859052
J Neurosurg. 2003 Sep;99(2 Suppl):162-8
pubmed: 12956458
Lancet. 2004 Dec 11-17;364(9451):2106-12
pubmed: 15589308
Neurology. 2007 Dec 11;69(24):2221-31
pubmed: 17928579
Spinal Cord. 2010 May;48(5):415-22
pubmed: 19901954
Anat Rec (Hoboken). 2011 Jan;294(1):46-54
pubmed: 21157915
Asian J Neurosurg. 2010 Jul;5(2):1-9
pubmed: 22028753
Br J Neurosurg. 2012 Aug;26(4):450-5
pubmed: 22107259
Spine (Phila Pa 1976). 2013 Jul 15;38(16):1409-21
pubmed: 23591658
Neuroradiology. 1990;32(2):117-23
pubmed: 2398937
Spine J. 2014 Aug 1;14(8):1601-10
pubmed: 24411833
Eur Spine J. 2014 Jul;23(7):1515-22
pubmed: 24781380
J Histochem Cytochem. 2014 Aug;62(8):598-611
pubmed: 24828513
Ann Neurol. 2014 Jul;76(1):54-65
pubmed: 24838831
Spine (Phila Pa 1976). 2015 Feb 15;40(4):E248-52
pubmed: 25423302
Spine (Phila Pa 1976). 2015 Feb 1;40(3):171-8
pubmed: 25668335
BMC Neurosci. 2016 Feb 05;17:10
pubmed: 26850728
Spine J. 2016 Nov;16(11):e751-e754
pubmed: 27293119
Radiology. 1989 Oct;173(1):219-24
pubmed: 2781011