Additional benefit of ultrasonography to evaluate nerve root condition of degenerative cervical spine disease

Kozuki, Hiroki; Tadokoro, Nobuaki; Aoyama, Naoki; Kiyasu, Katsuhito; Takemasa, Ryuichi; Ikeuchi, Masahiko

doi:10.1038/s41393-022-00865-z

Cited by 2 publications

(3 citation statements)

References 23 publications

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“…In the present study, when the cutoff value of AH muscle potential evoked by peripheral nerve stimulation was set at 11.2 mV, ALS and CCM could be differentiated with relatively high accuracy (sensitivity and specificity of 87.5% and 85.7%, respectively). However, it has been reported that CMAP amplitude is reduced in patients with cervical spondylotic amyotrophy, but not commonly in those with CCM 26,27 . In patients with suspected cervical spondylotic amyotrophy, discrimination based on CMAP amplitude requires careful consideration.…”

Section: Discussionmentioning

confidence: 99%

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Differentiating Neurodegenerative Disease from Compressive Cervical Myelopathy Using Motor Evoked Potentials

Kamei

Nakamae

Maruyama

et al. 2023

Spine

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Study Design. A retrospective case-control study. Objective. To differentiate neurodegenerative diseases from compressive cervical myelopathy (CCM) using motor-evoked potentials (MEPs). Summary of Background Data. When considering surgery for CCM, it may be necessary to differentiate the condition from a neurodegenerative disease. Materials and Methods. A total of 30 healthy volunteers, 52 typical CCM patients with single-level compression of the spinal cord at C4-5 or C5-6, 7 patients with amyotrophic lateral sclerosis (ALS), and 12 patients with demyelinating disease of the central nervous system, including 11 patients with multiple sclerosis and 1 patient with neuromyelitis optica spectrum disorder, formed our study population. MEPs were recorded from the bilateral abductor digiti minimi (ADM) and abductor hallucis (AH) muscles using transcranial magnetic stimulation and electrical stimulation of the ulnar and tibial nerves. Central motor conduction time, peripheral conduction time, amplitude of MEPs, and frequency of F waves were evaluated. Receiver operating characteristic curve analysis was used to determine the cutoff value for distinguishing between CCM and ALS. Results. Significant differences were observed in the amplitude of MEPs and frequency of F waves evoked by peripheral nerve stimulation between patients with CCM and ALS. The MEP amplitude of AH was more accurate in differentiating between the two diseases compared with ADM (cutoff value, 11.2 mV, sensitivity, 87.5%; specificity, 85.7%). All 7 patients with ALS showed reduced frequency of F waves from ADM or AH, but none of the healthy volunteers or patients with other diseases demonstrated this finding. Moreover, there were no significant differences between CCM and demyelinating disease of the central nervous system in any of the assessments. Conclusion. The amplitude of MEPs and frequency of F waves evoked by peripheral nerve stimulation could be helpful in differentiating ALS from CCM.

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Section: Discussionmentioning

confidence: 99%

“…However, it has been reported that CMAP amplitude is reduced in patients with cervical spondylotic amyotrophy, but not commonly in those with CCM. 26,27 In patients with suspected cervical spondylotic amyotrophy, discrimination based on CMAP amplitude requires careful consideration.…”

Section: Discussionmentioning

confidence: 99%

Differentiating Neurodegenerative Disease from Compressive Cervical Myelopathy Using Motor Evoked Potentials

Kamei

Nakamae

Maruyama

et al. 2023

Spine

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“…Literature indicates that surgical treatment is only considered when the pain is severe, conservative treatment has failed, or muscle weakness and atrophy are evident [23]. However, conclusive evidence to determine the indications for conservative CSR treatment and accurate surgical treatment timing is still lacking in the current clinical practice guidelines [24][25][26]. Therefore, this study explores the relation between cervical sagittal parameters and the e cacy of conservative CSR treatment and reveas that the K-line tilt has a particular predictive effect on the e cacy of conservative treatment, providing a reference for cervical radiculopathy treatment decision.…”

Section: Discussionmentioning

confidence: 99%

K-line tilt: A novel potential predictive indicator for the effectiveness of conservative cervical spondylotic radiculopathy management

Deng,

Zhou,

Zhou

et al. 2023

Preprint

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Background: Cervical spondylotic radiculopathy is a prevalent degenerative cervical spine disease. K-line tilt is a recently discovered cervical spine sagittal plane parameter. However, the relationship between K-line tilt and conservative cervical spondylotic radiculopathy management remains unknown. Methods: We retrospectively analyzed the clinical records of 188 patients with cervical spondylotic radiculopathy who were conservatively treated at our hospital from May 2016 to May 2022. The effective and ineffective conservative treatment groups included 90 patients and 98 patients, respectively. Cervical sagittal parameters, including K-line tilt, C2–C7 sagittal plane axial vertical distance (C2–C7 SVA), T1 slope, and C2–C7 lordosis, were measured and compared. Multiple logistic regressions were conducted to analyze risk factors for effective conservative treatment. Results: The results revealed that K-line tilt and C2–C7 lordosis were significantly different for the effective and ineffective groups (P < 0.05). Multifactorial regression analysis revealed a K-line tilt of <6.11° as a risk factor for effective conservative cervical spondylotic radiculopathy treatment (P < 0.05), and receiver operating characteristic curves demonstrated a moderate diagnostic value with an area under the curve of 0.77. Conclusions: This study confirms K-line tilt (<6.11°) as a potential risk factor for the effectiveness of conservative cervical spondylotic radiculopathy treatment. Conservative treatment may be less effective when the K-line tilt of the cervical spine is >6.11°.

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Additional benefit of ultrasonography to evaluate nerve root condition of degenerative cervical spine disease

Cited by 2 publications

References 23 publications

Differentiating Neurodegenerative Disease from Compressive Cervical Myelopathy Using Motor Evoked Potentials

Differentiating Neurodegenerative Disease from Compressive Cervical Myelopathy Using Motor Evoked Potentials

K-line tilt: A novel potential predictive indicator for the effectiveness of conservative cervical spondylotic radiculopathy management

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