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Spinal Cord Motion in Degenerative Cervical Myelopathy: The Level of the Stenotic Segment and Gender Cause Altered Pathodynamics

In degenerative cervical myelopathy (DCM), focally increased spinal cord motion has been observed for C5/C6, but whether stenoses at other cervical segments lead to similar pathodynamics and how severity of stenosis, age, and gender affect them is still unclear. We report a prospective matched-pair...

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Autores principales: Wolf, Katharina, Reisert, Marco, Beltrán, Saúl Felipe, Klingler, Jan-Helge, Hubbe, Ulrich, Krafft, Axel J., Kremers, Nico, Egger, Karl, Hohenhaus, Marc
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432264/
https://www.ncbi.nlm.nih.gov/pubmed/34501236
http://dx.doi.org/10.3390/jcm10173788
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author Wolf, Katharina
Reisert, Marco
Beltrán, Saúl Felipe
Klingler, Jan-Helge
Hubbe, Ulrich
Krafft, Axel J.
Kremers, Nico
Egger, Karl
Hohenhaus, Marc
author_facet Wolf, Katharina
Reisert, Marco
Beltrán, Saúl Felipe
Klingler, Jan-Helge
Hubbe, Ulrich
Krafft, Axel J.
Kremers, Nico
Egger, Karl
Hohenhaus, Marc
author_sort Wolf, Katharina
collection PubMed
description In degenerative cervical myelopathy (DCM), focally increased spinal cord motion has been observed for C5/C6, but whether stenoses at other cervical segments lead to similar pathodynamics and how severity of stenosis, age, and gender affect them is still unclear. We report a prospective matched-pair controlled trial on 65 DCM patients. A high-resolution 3D T2 sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) and a phase-contrast magnetic resonance imaging (MRI) sequence were performed and automatically segmented. Anatomical and spinal cord motion data were assessed per segment from C2/C3 to C7/T1. Spinal cord motion was focally increased at a level of stenosis among patients with stenosis at C4/C5 (n = 14), C5/C6 (n = 33), and C6/C7 (n = 10) (p < 0.033). Patients with stenosis at C2/C3 (n = 2) and C3/C4 (n = 6) presented a similar pattern, not reaching significance. Gender was a significant predictor of higher spinal cord dynamics among men with stenosis at C5/C6 (p = 0.048) and C6/C7 (p = 0.033). Age and severity of stenosis did not relate to spinal cord motion. Thus, the data demonstrates focally increased spinal cord motion depending on the specific level of stenosis. Gender-related effects lead to dynamic alterations among men with stenosis at C5/C6 and C6/C7. The missing relation of motion to severity of stenosis underlines a possible additive diagnostic value of spinal cord motion analysis in DCM.
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spelling pubmed-84322642021-09-11 Spinal Cord Motion in Degenerative Cervical Myelopathy: The Level of the Stenotic Segment and Gender Cause Altered Pathodynamics Wolf, Katharina Reisert, Marco Beltrán, Saúl Felipe Klingler, Jan-Helge Hubbe, Ulrich Krafft, Axel J. Kremers, Nico Egger, Karl Hohenhaus, Marc J Clin Med Article In degenerative cervical myelopathy (DCM), focally increased spinal cord motion has been observed for C5/C6, but whether stenoses at other cervical segments lead to similar pathodynamics and how severity of stenosis, age, and gender affect them is still unclear. We report a prospective matched-pair controlled trial on 65 DCM patients. A high-resolution 3D T2 sampling perfection with application-optimized contrasts using different flip angle evolution (SPACE) and a phase-contrast magnetic resonance imaging (MRI) sequence were performed and automatically segmented. Anatomical and spinal cord motion data were assessed per segment from C2/C3 to C7/T1. Spinal cord motion was focally increased at a level of stenosis among patients with stenosis at C4/C5 (n = 14), C5/C6 (n = 33), and C6/C7 (n = 10) (p < 0.033). Patients with stenosis at C2/C3 (n = 2) and C3/C4 (n = 6) presented a similar pattern, not reaching significance. Gender was a significant predictor of higher spinal cord dynamics among men with stenosis at C5/C6 (p = 0.048) and C6/C7 (p = 0.033). Age and severity of stenosis did not relate to spinal cord motion. Thus, the data demonstrates focally increased spinal cord motion depending on the specific level of stenosis. Gender-related effects lead to dynamic alterations among men with stenosis at C5/C6 and C6/C7. The missing relation of motion to severity of stenosis underlines a possible additive diagnostic value of spinal cord motion analysis in DCM. MDPI 2021-08-25 /pmc/articles/PMC8432264/ /pubmed/34501236 http://dx.doi.org/10.3390/jcm10173788 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wolf, Katharina
Reisert, Marco
Beltrán, Saúl Felipe
Klingler, Jan-Helge
Hubbe, Ulrich
Krafft, Axel J.
Kremers, Nico
Egger, Karl
Hohenhaus, Marc
Spinal Cord Motion in Degenerative Cervical Myelopathy: The Level of the Stenotic Segment and Gender Cause Altered Pathodynamics
title Spinal Cord Motion in Degenerative Cervical Myelopathy: The Level of the Stenotic Segment and Gender Cause Altered Pathodynamics
title_full Spinal Cord Motion in Degenerative Cervical Myelopathy: The Level of the Stenotic Segment and Gender Cause Altered Pathodynamics
title_fullStr Spinal Cord Motion in Degenerative Cervical Myelopathy: The Level of the Stenotic Segment and Gender Cause Altered Pathodynamics
title_full_unstemmed Spinal Cord Motion in Degenerative Cervical Myelopathy: The Level of the Stenotic Segment and Gender Cause Altered Pathodynamics
title_short Spinal Cord Motion in Degenerative Cervical Myelopathy: The Level of the Stenotic Segment and Gender Cause Altered Pathodynamics
title_sort spinal cord motion in degenerative cervical myelopathy: the level of the stenotic segment and gender cause altered pathodynamics
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8432264/
https://www.ncbi.nlm.nih.gov/pubmed/34501236
http://dx.doi.org/10.3390/jcm10173788
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