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Spinal Cord. 2013 Oct;51(10):761-4. doi: 10.1038/sc.2013.94. Epub 2013 Sep 3.

Influence of intramedullary stress on cervical spondylotic myelopathy.

Author information

1
1] Department of Orthopaedic Surgery, Tohoku University School of Medicine, Sendai, Japan [2] Department of Orthopaedic Surgery, Senboku Kumiai Hospital, Akita, Japan.

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.

PMID:
23999109
DOI:
10.1038/sc.2013.94
[Indexed for MEDLINE]

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