Association Between Paraspinal Muscle Morphology, Clinical Symptoms, and Functional Status in Patients With Degenerative Cervical Myelopathy

Fortin, Maryse; Dobrescu, Octavian; Courtemanche, Matthew; Sparrey, Carolyn J.; Santaguida, Carlo; Fehlings, Michael G.; Weber, Michael H.

doi:10.1097/brs.0000000000001704

Cited by 50 publications

(76 citation statements)

References 35 publications

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“…4 ). We base this decision in part on previous work in the cervical spine [ 3 , 5 , 6 , 27 , 41 ]. Such an approach has revealed not only improved inter- and intra-rater reliability when following the spinous process and/or lamina in the cervical spine, but also the ability to discriminate between clinical groups [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…Fat (F)-Water (W) Fat Infiltration % MFI = (fat signal)/(fat signal + water signal) *100 Elliott et al, 2014 [ 8 ] From Elliott et al, 2007 [ 47 ] for CSA Intra- rater (0.84–0.99) Inter-rater (0.89–0.96) T1 Axial images aligned parallel to C2–3 IVD; measurements from single slice crossing IVDs C2-C3 and C5-C6 MF SSCerv SSCap SpCap LCap/LCol SCM Manual Quantitative Pixel Intensity Fat Infiltration %MFI = (fat signal)/(fat signal + water signal)*100 CSA Elliott et al, 2015 [ 3 ] Not reported Dixon Measurements from single slice per vertebral level C3-C7; alignment and slice selection not reported MF Manual Fat-Water Fat Infiltration %MFI = (fat signal)/(fat signal + water signal)*100 Abbott et al, 2015 [ 6 ] Intra-rater (0.98) Inter-rater (0.93) Dixon Measurements averaged over 5 slices for each vertebral level C3-C7; Slab alignment not reported. MF + SSCerv (combined) Manual with automatic quartile measure Fat-Water Fat Infiltration %MFI = (fat signal)/(fat signal + water signal)*100 Karlsson et al, 2016 [ 5 ] For muscle fat Intra-rater (0.81–0.93) Inter-rater (0.82–0.97) Dixon Axial images aligned parallel to vertebral segments; measurements averaged over 5 slices for each vertebral level C4-C7 MF Manual Fat-Water Fat Infiltration %MFI = (fat signal)/(fat signal + water signal)*100 CSA Au et al, 2016 [ 57 ] Not reported T1 Axial images aligned parallel to C2–3 intervertebral disc; 3D reconstruction IC, IS, LS, LoCap, LoC, LCap, LCol, MF, LoCap, LoCerv, SSCap, SSCerv, SCM, UT Manual N/A N/A Fortin et al, 2017 [ 27 ] Fortin et al, 2018 [ 81 ] From [ 81 ]:Intra-rater (0.83–0.99) Inter-rater (0.38–0.98) …”

Section: Methodsmentioning

confidence: 99%

“…While data for age-related, degenerative changes of tissues (e.g. vertebrae, joints, discs, muscles) of the lumbar and cervical spine have been published [ 16 – 27 ], studies assessing age-related alterations in paravertebral muscle morphology [ 19 , 28 , 29 ] remain unique to the healthy lumbar spine. Such normative data, to our knowledge, does not exist for the cervical spine.…”

Section: Introductionmentioning

confidence: 99%

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Towards defining muscular regions of interest from axial magnetic resonance imaging with anatomical cross-reference: part II - cervical spine musculature

Elliott

Cornwall

Kennedy

et al. 2018

BMC Musculoskelet Disord

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BackgroundIt has been suggested that the quantification of paravertebral muscle composition and morphology (e.g. size/shape/structure) with magnetic resonance imaging (MRI) has diagnostic, prognostic, and therapeutic potential in contributing to overall musculoskeletal health. If this is to be realised, then consensus towards standardised MRI methods for measuring muscular size/shape/structure are crucial to allow the translation of such measurements towards management of, and hopefully improved health for, those with some musculoskeletal conditions. Following on from an original paper detailing methods for measuring muscles traversing the lumbar spine, we propose new methods based on anatomical cross-reference that strive towards standardising MRI-based quantification of anterior and posterior cervical spine muscle composition.MethodsIn this descriptive technical advance paper we expand our methods from the lumbar spine by providing a detailed examination of regional cervical spine muscle morphology, followed by a comprehensive description of the proposed technique defining muscle ROI from axial MRI. Cross-referencing cervical musculature and vertebral anatomy includes an innovative comparison between axial E12 sheet-plastinates derived from cadaveric material to a series of axial MRIs detailing commonly used sequences. These images are shown at different cervical levels to illustrate differences in regional morphology. The method for defining ROI for both anterior (scalenes group, sternocleidomastoid, longus colli, longus capitis) and posterior (multifidus, semispinalis cervicis, semispinalis capitis, splenius capitis) cervical muscles is then described and discussed in relation to existing literature.ResultsA series of steps towards standardising the quantification of cervical spine muscle quality are described, with concentration on the measurement of muscle volume and fatty infiltration (MFI). We offer recommendations for imaging parameters that should additionally inform a priori decisions when planning investigations of cervical muscle tissues with MRI.ConclusionsThe proposed method provides an option rather than a final position for quantifying cervical spine muscle composition and morphology using MRI. We intend to stimulate discussion towards establishing measurement consensus whereby data-pooling and meaningful comparisons between imaging studies (primarily MRI) investigating cervical muscle quality becomes available and the norm.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Towards defining muscular regions of interest from axial magnetic resonance imaging with anatomical cross-reference: part II - cervical spine musculature

Elliott

Cornwall

Kennedy

et al. 2018

BMC Musculoskelet Disord

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“…[15] Fortin et al reported that a significant increase in the asymmetry of CSA of multifidus muscles was present at the level below spinal cord compression in the patients with cervical myelopathy. [17]…”

Section: Discussionmentioning

confidence: 99%

Asymmetric atrophy of cervical multifidus muscles in patients with chronic unilateral cervical radiculopathy

et al. 2019

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The purpose of this study was to assess whether the asymmetry of cervical multifidus muscles occurred in radiculopathy patients, and if it did, whether it was related to the chronicity of unilateral cervical radiculopathy by assessing the cross-sectional area (CSA) of multifidus muscles using magnetic resonance imaging (MRI). This study used a retrospective design and was conducted from January 2013 to August 2016. Seventy-seven patients (age 18–65) who had unilateral neck pain, symptom duration of 3 months to 1 year, and who were diagnosed with unilateral 6th cervical radiculopathy by electrodiagnostic testing, were included in study. The CSA of cervical multifidus muscles was measured at the midpoint between the lower margin of the upper vertebra and upper margin of the lower vertebra on axial MRI. Relative CSA (rCSA), which is the ratio of the CSA of muscles to that of the lower margin of C5 vertebra was also obtained. At the C4-5 and C6-7 levels, CSA and rCSA of cervical multifidus muscles showed no statistically difference between the affected and unaffected sides. At the C5-6 level, multifidus muscles were significantly smaller in the affected side (at the C5-6 level, P value of CSA.007 and P value of rCSA.102). The atrophy of multifidus muscles ipsilateral to cervical radiculopathy was observed in patients who had chronic unilateral cervical radiculopathy.

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“…We expect to achieve an increase in muscle strength that can be quantified by an increase in the functional cross-sectional area of these muscles seen on magnetic resonance images. 38 The study has several weaknesses. First, we discarded 20% to 24% of the data collected because of dislodged or noisy electrodes or implausible values.…”

Section: Discussionmentioning

confidence: 99%

Forward Head Posture and Activation of Rectus Capitis Posterior Muscles

Hallgren¹,

Pierce

Sharma

et al. 2017

Journal of Osteopathic Medicine

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Association Between Paraspinal Muscle Morphology, Clinical Symptoms, and Functional Status in Patients With Degenerative Cervical Myelopathy

Abstract: 2.

Cited by 50 publications

References 35 publications

Towards defining muscular regions of interest from axial magnetic resonance imaging with anatomical cross-reference: part II - cervical spine musculature

Towards defining muscular regions of interest from axial magnetic resonance imaging with anatomical cross-reference: part II - cervical spine musculature

Asymmetric atrophy of cervical multifidus muscles in patients with chronic unilateral cervical radiculopathy

Forward Head Posture and Activation of Rectus Capitis Posterior Muscles

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