Influence of intramedullary stress on cervical spondylotic myelopathy.
Spinal Cord
; 51(10): 761-4, 2013 Oct.
Article
in En
| MEDLINE
| ID: mdl-23999109
ABSTRACT
STUDY DESIGN:
A cross-sectional analysis.OBJECTIVE:
To examine whether intramedullary stress is related to the appearance of symptoms in cervical spondylotic myelopathy (CSM).SETTING:
Japan.METHODS:
Thirty-three consecutive patients with CSM and 30 consecutive patients without CSM were enrolled. A total of 99 disc levels from C3 to C6 in 33 patients with CSM were divided into two groups 33 disc levels with high signal intensity (HSI) on T2-weighted magnetic resonance image (HSI group) and 66 disc levels without HSI (Non-HSI group). Ninety disc levels from C3 to C6 in patients without CSM were set up in a control group. Intramedullary stress value at each level was analyzed using the finite element method. Stress was compared among the three groups. A cutoff value of stress to present HSI was investigated from receiver operator characteristics (ROC) curve.RESULTS:
In all the patients with CSM, the disc level with HSI presented the highest stress among the three disc levels evaluated. The stress was 3.16 ± 0.86 kPa (mean ± s.d.) in the HSI group, 1.81 ± 0.72 kPa in the Non-HSI group and 1.01 ± 0.37 kPa in the control group. The stress differed significantly among the three groups (P<0.0001). The qualified cutoff value derived from the ROC curve was 2.30 kPa (sensitivity 78.8%, specificity 91.9%). None of the disc levels in the control group exceeded 2.30 kPa.CONCLUSION:
HSI was strongly associated with intramedullary stress. Threshold of intramedullary stress to present HSI that related closely to the symptoms of myelopathy was revealed.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Spinal Cord Diseases
/
Spinal Cord Injuries
/
Stress, Physiological
Type of study:
Etiology_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Asia
Language:
En
Journal:
Spinal Cord
Journal subject:
NEUROLOGIA
Year:
2013
Document type:
Article
Affiliation country:
Japan