Difference of Dynamic Morphometric Changes Between in Patients with Ossification of Posterior Longitudinal Ligament and Patients with Cervical Spondylosis: Assessment by Cervical Dynamic Magnetic Resonance Imaging

Lee, Jong Beom; Kim, Il Sup; Kwon, Jae Yoel; Lee, Jung Jae; Park, Jong-Hyeok; Cho, Chul Bum; Yang, Seung Ho; Sung, Jae Hoon; Hong, Jae Taek

doi:10.1016/j.wneu.2018.11.213

Cited by 9 publications

(6 citation statements)

References 23 publications

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“…Reporting the analysis of a cohort of 2471 patients, Hayashi et al 80 identified missed dynamic compression in cervical extension in 8.3% of patients, and in 1.6% of patients in flexion, with the most frequently missed level being C5–C6. Lee et al 81 reported that cervical canal diameter was more significantly reduced in dynamic MRI of patients with DCM from degenerative/spondylotic changes rather than that resulting from OPLL. Nigro et al 82 suggested that dynamic MRI was more useful for diagnosing posterior compression, whereas anterior compression was more often diagnosed with static MRI.…”

Section: Areas Of Uncertaintymentioning

confidence: 99%

Optimizing the Application of Surgery for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 10]

Rodrigues-Pinto

Montenegro

Davies

et al. 2022

Global Spine Journal

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Study Design Literature Review (Narrative). Objective To introduce the number 10 research priority for Degenerative Cervical Myelopathy: Individualizing Surgery. Methods This article summarizes the current recommendations and indications for surgery, including how known prognostic factors such as injury time, age, disease severity, and associated comorbidities impact surgical outcome. It also considers key areas of uncertainty that should be the focus of future research. Results While a small proportion of conservatively managed patients may remain stable, the majority will deteriorate over time. To date, surgical decompression is the mainstay of treatment, able to halt disease progression and improve neurologic function and quality of life for most patients. Whilst this recognition has led to recommendations on when to offer surgery, there remain many uncertainties including the type of surgery, or timing in milder and/or asymptomatic cases. Their clarification has the potential to transform outcomes, by ensuring surgery offers each individual its maximum benefit. Conclusion Developing the evidence to better guide surgical decision-making at the individual patient level is a research priority for Degenerative Cervical Myelopathy.

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Section: Areas Of Uncertaintymentioning

confidence: 99%

Optimizing the Application of Surgery for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 10]

Rodrigues-Pinto

Montenegro

Davies

et al. 2022

Global Spine Journal

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“…For instance, secondary to the degenerated intravertebral disc, the intradiscal height and intravertebral space would substantially decrease. Upon extension, the ligamentum flavum would get thicker significantly during the process of neutral to extension position [32] and bulking toward the canal [29,[33][34][35]. As a result, the diameter of the spinal canal reduces significantly, especially in C3-C6 [32,36], and creates dorsal spinal cord compression.…”

Section: Dynamic Factorsmentioning

confidence: 99%

Surgical Treatment of Cervical Spondylotic Myelopathy

Chen,

Zhang,

Chen

et al. 2023

IJCEMR

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Cervical spondylotic myelopathy (CSM) is the leading cause of spinal cord injury in adults. The typical symptoms of CSM are poor hand dexterity and unsteady gait pattern, which prevent patients from completing fine movements, seriously affecting their quality of life. Surgical treatment is generally recommended for patients who have moderate to severe CSM and who have received conservative treatment but whose symptoms are still progressing. However, the choice of surgical method has been controversial due to the diversity of surgical procedures of CSM. For spine surgeons, understanding the features of different procedures can greatly assist them in making clinical decisions. Based on the different approaches, operative treatments can be grouped into anterior surgery, posterior surgery, and combined anterior and posterior surgery. Anterior surgeries include anterior cervical discectomy and fusion (ACDF), anterior cervical corpectomy and fusion (ACCF), as well as cervical disc replacement (CDR). Posterior surgeries consist of laminectomy and laminoplasty. For patients with a complex pathophysiology and more severe CSM, combined anterior-posterior surgery, such as posterior laminoplasty or laminectomy and fusion combined with ACDF or ACCF, is often recommended. Additionally, ACDF has been applicated as the mainstay of treatment for CSM patients whose compression is confined to the disc level and has fewer than three compression segments, but the high incidence of complication should be expected, as well as the high readmission rate and additional costs. Meanwhile, as knowledge about CSM and its surgical treatment continues to expand, many trials have demonstrated the superiority of CDR in preserving the mobility of the index segments and reducing the incidence of complications. Therefore, CDR could be a better option than ACDF for patients with similar pathological changes but relatively stable cervical spine. This article summarized the pathophysiology of CSM as well as the characteristics, indications, clinical efficacy, and safety of various surgical treatments, and pays special attention to the clinical selection of CDR and ACDF, which can provide a more comprehensive reference for spine surgeons to make clinical decisions about CSM surgery.

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“…Lee et al [15] performed dMRI in 66 patients with CSM and 22 patients with ossification of the posterior longitudinal ligament (OPLL). They evaluated the cervical spine according to the Muhle’s grade of stenosis as well as canal diameters and LF thickness in standard and dMRI.…”

Section: Dynamic Mri Studiesmentioning

confidence: 99%

Dynamic Cord Compression Causing Cervical Myelopathy

et al. 2019

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Due to the highly mobile nature of the cervical spine, and the fact that most magnetic resonance imagings (MRIs) and computed tomography scans are obtained only in one single position, dynamic cord compression can be an elusive diagnosis that is often missed and not well-understood. In this context, dynamic MRI (dMRI) has been utilized to improve the diagnostic accuracy of cervical stenosis. We performed a literature review on dynamic cord compression in the context of cervical spondylotic myelopathy (CSM), with particular emphasis on the role of dMRI. Cadaveric studies report that the spinal cord lengthens in flexion and the spinal canal dimension increases, whereas the spinal cord relaxes and shortens in extension and the spinal canal decreases. These changes may lead to biomechanical stress in the spinal cord with movement, especially in patients with critical cervical stenosis. The majority of the studies using dMRI in CSM reported that this imaging modality is more sensitive at detecting cervical cord compression compared to routine MRIs done in a neutral position, especially with the neck in extension. Dynamic MRI was also useful to diagnose dynamic cervical cord compression after laminectomies in patients with clinical deterioration without evident cord compression on neutral static MRI. Finally, dMRI is more sensitive in detecting stenosis in patients with CSM than in those with ossification of the posterior longitudinal ligament (OPLL), likely because OPLL patients often have a more limited range of motion than CSM patients. Thus, dMRI is a promising new tool that can help spine surgeons in diagnosing and treating CSM.

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Difference of Dynamic Morphometric Changes Between in Patients with Ossification of Posterior Longitudinal Ligament and Patients with Cervical Spondylosis: Assessment by Cervical Dynamic Magnetic Resonance Imaging

Cited by 9 publications

References 23 publications

Optimizing the Application of Surgery for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 10]

Optimizing the Application of Surgery for Degenerative Cervical Myelopathy [AO Spine RECODE-DCM Research Priority Number 10]

Surgical Treatment of Cervical Spondylotic Myelopathy

Dynamic Cord Compression Causing Cervical Myelopathy

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