How old is your cervical spine? Cervical spine biological age: a new evaluation scale

Wierzbicki, Venceslao; Pesce, Alessandro; Marrocco, Luigi; Piccione, Emanuele; Colonnese, Claudio; Caruso, Riccardo

doi:10.1007/s00586-014-3673-4

Cited by 13 publications

(6 citation statements)

References 30 publications

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“…Furthermore, high scores in the three scales relate to dependence, which can be measured with the Glasgow Outcome Scale-Extended (GOSE) [ 39 ] 6 months after DAI [ 10 ]. The aforementioned scales take in account the clinical impact of possible concurrent lesions involving other organs or other collateral conditions, including intracranial bleeding, cranial base and vault lesions [ 40 ], and spinal cord or vertebral lesions. Moreover, it has been described that pre-existing conditions, namely other major comorbidities and aging-related changes to tissues and metabolism could worsen the injury caused by the trauma [ 30 , 40 , 41 ].…”

Section: Severity Of Traumamentioning

confidence: 99%

Diffuse Axonal Injury: Clinical Prognostic Factors, Molecular Experimental Models and the Impact of the Trauma Related Oxidative Stress. An Extensive Review Concerning Milestones and Advances

Palmieri

Frati

Santoro

et al. 2021

IJMS

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Traumatic brain injury (TBI) is a condition burdened by an extremely high rate of morbidity and mortality and can result in an overall disability rate as high as 50% in affected individuals. Therefore, the importance of identifying clinical prognostic factors for diffuse axonal injury (DAI) in (TBI) is commonly recognized as critical. The aim of the present review paper is to evaluate the most recent contributions from the relevant literature in order to understand how each single prognostic factor determinates the severity of the clinical syndrome associated with DAI. The main clinical factors with an important impact on prognosis in case of DAI are glycemia, early GCS, the peripheral oxygen saturation, blood pressure, and time to recover consciousness. In addition, the severity of the lesion, classified on the ground of the cerebral anatomical structures involved after the trauma, has a strong correlation with survival after DAI. In conclusion, modern findings concerning the role of reactive oxygen species (ROS) and oxidative stress in DAI suggest that biomarkers such as GFAP, pNF-H, NF-L, microtubule associated protein tau, Aβ42, S-100β, NSE, AQP4, Drp-1, and NCX represent a possible critical target for future pharmaceutical treatments to prevent the damages caused by DAI.

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Section: Severity Of Traumamentioning

confidence: 99%

Diffuse Axonal Injury: Clinical Prognostic Factors, Molecular Experimental Models and the Impact of the Trauma Related Oxidative Stress. An Extensive Review Concerning Milestones and Advances

Palmieri

Frati

Santoro

et al. 2021

IJMS

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“…No individual phenotype was capable of similar predictions; thereby, suggesting that the CPI may serve as a useful prognostic tool for quantifying degeneration in the spine. Unlike other age‐related and degenerative cervical spine scoring systems reported in the literature, the CPI has demonstrated efficacy as a determinant of clinical outcomes 24,29 . However, when calculated at the levels immediately adjacent to the fusion construct, distal adjacent level CPI scores were capable of similar predictions, while proximal scores were inconclusive.…”

Section: Discussionmentioning

confidence: 98%

“… 24,29. However, when calculated at the levels immediately adjacent to the fusion construct, distal adjacent level CPI scores were capable of similar predictions, while proximal scores were inconclusive.…”

mentioning

confidence: 89%

Cervical spine MRI phenotypes and prediction of pain, disability and adjacent segment degeneration/disease after ACDF

Harada

Tao²,

Louie

et al. 2020

Journal Orthopaedic Research

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Degenerative spine imaging findings have been extensively studied in the lumbar region and are associated with pain and adverse clinical outcomes after surgery. However, few studies have investigated the significance of these imaging “phenotypes” in the cervical spine. Patients with degenerative cervical spine pathology undergoing anterior cervical discectomy and fusion (ACDF) from 2008 to 2015 were retrospectively and prospectively assessed using preoperative MRI for disc degeneration, narrowing, and displacement, high‐intensity zones, endplate abnormalities, Modic changes, and osteophyte formation from C2‐T1. Points were assigned for these phenotypes to generate a novel Cervical Phenotype Index (CPI). Demographics were evaluated for association with phenotypes and the CPI using forward stepwise regression. Bootstrap sampling and multiple imputations assessed phenotypes and the CPI in association with patient‐reported outcomes (Neck Disability Index [NDI], Visual Analog Scale [VAS]‐neck, VAS‐arm) and adjacent segment degeneration (ASDeg) and disease (ASDz). Of 861 patients, disc displacement was the most common (99.7%), followed by osteophytes (92.0%) and endplate abnormalities (57.3%). Most findings were associated with age and were identified at similar cervical vertebral levels; at C5‐C7. Imaging phenotypes demonstrated both increased and decreased associations with adverse patient‐reported outcomes and ASDeg/Dz. However, the CPI consistently predicted worse NDI (P = .012), VAS‐neck (P = .007), and VAS‐arm (P = .013) scores, in addition to higher odds of ASDeg (P = .002) and ASDz (P = .004). The CPI was significantly predictive of postoperative symptoms of pain/disability and ASDeg/Dz after ACDF, suggesting that the totality of degenerative findings may be more clinically relevant than individual phenotypes and that this tool may help prognosticate outcomes after surgery.

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“…In comparison with other scoring scales in the field the agreement is regarded equivalent. Considering inter-rater reliability of the assessment of disc degeneration, previous scales vary from 0.41–0.78 [16, 28, 29] intra-rater reliability of the discs vary from 0.71–0.86 [16, 29]. In the material reviewed, the inter-rater agreement for facet joint degeneration the agreement varied from 0.43–0.49 [15, 16] and the intra-rater agreement from 0.57–0.72 [15, 16].…”

Section: Discussionmentioning

confidence: 99%

Quantifying cervical spondylosis: reliability testing of a coherent CT-based scoring system

Rydman

Bankler²,

Ponzer

et al. 2019

BMC Med Imaging

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Background Grading of degeneration of the cervical spine is of great clinical value, considering the vast amount of radiological investigations that are being done with this query. Despite the fact that Computed Tomography (CT) is frequently used in clinical practice there is today no user-friendly and reliable scoring system for assessment of cervical spondylosis on CT-scans available. The aim of this study was to establish a scoring system for cervical spondylosis based on CT-scans and to test it for reliability. Methods Twenty adult patients undergoing CT of the cervical spine due to neck pain following a motor vehicle accident were included in the study. Three independent raters, i.e. one orthopedic surgeon and two radiologists, assessed their CT-scans. Two of the raters repeated the assessments after three months. A radiographic-based scoring system for cervical disc degeneration, addressing disc height, osteophytes and endplate sclerosis, was applied on CT and tested for reliability. A pre-existing, reliable CT-based scoring system for facet joint degeneration, considering joint space narrowing, osteophytes and irregularity of the articular surface was modified and reevaluated. This in order to develop a coherent CT-based total degeneration score for cervical spondylosis. Results The scoring systems for cervical disc degeneration and facet joint degeneration both exhibited an acceptable or better level of strength of agreement regarding intra- and interrater agreement. The total disc degeneration score showed a moderate level of inter-rater reliability with a kappa-value of 0.47 and a good intra-rater agreement with intra-class correlation coefficients (ICC) of 0.67 and 0.60 for the two raters performing the assessments. The total facet joint degeneration score showed a moderate level of inter-rater reliability (kappa 0.54) and an excellent intra-rater agreement with ICC 0.75 for one of the raters and fair for the other rater (ICC 0.54). When the total disc and facet joint degeneration score were classified into a three-point total degeneration score the inter-rater agreement was 0.695 and the ICC 0.82 and 0.73 respectively. Conclusions This coherent scoring system assessing both disc degeneration and facet joint degeneration on CT-scans of the cervical spine was shown to meet the standards of reliability.

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How old is your cervical spine? Cervical spine biological age: a new evaluation scale

Cited by 13 publications

References 30 publications

Diffuse Axonal Injury: Clinical Prognostic Factors, Molecular Experimental Models and the Impact of the Trauma Related Oxidative Stress. An Extensive Review Concerning Milestones and Advances

Diffuse Axonal Injury: Clinical Prognostic Factors, Molecular Experimental Models and the Impact of the Trauma Related Oxidative Stress. An Extensive Review Concerning Milestones and Advances

Cervical spine MRI phenotypes and prediction of pain, disability and adjacent segment degeneration/disease after ACDF

Quantifying cervical spondylosis: reliability testing of a coherent CT-based scoring system

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