The relationship between central motor conduction time and spinal cord compression in patients with cervical spondylotic myelopathy

Rikita, T; Tanaka, Nobuhiro; Nakanishi, Kazuyoshi; Kamei, Naosuke; Sumiyoshi, Norihiko; Kotaka, Shinji; Adachi, Nobuo; Ochi, Mitsuo

doi:10.1038/sc.2016.130

Cited by 14 publications

(12 citation statements)

References 15 publications

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“…CMCT is a test based on motor evoked potentials (MEPs), and it is used to determine the presence or absence of pathology in the brain and the spine [70]. In order to induce an MEP, electrodes are attached to the muscles in the upper or lower limbs, and magnetic stimulation is delivered to the scalp [70]. Electric stimulation is initiated in the corticospinal tract of the brain cortex and is delivered to the muscles in the limb where the electrodes are attached, inducing muscle contraction.…”

Section: Central Motor Conduction Time Studymentioning

confidence: 99%

Diagnostic Modality in Spine Disease: A Review

et al. 2020

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Spine diseases are common and exhibit several causes, including degeneration, trauma, congenital issues, and other specific factors. Most people experience a variety of symptoms of spine diseases during their lifetime that are occasionally managed with conservative or surgical treatments. Accurate diagnosis of the spine pathology is essential for the appropriate management of spine disease, and various imaging modalities can be used for the diagnosis, including radiography, computed tomography (CT), magnetic resonance imaging (MRI), and other studies such as EOS, bone scan, single photon emission CT/CT, and electrophysiologic test. Patient (or case)-specific selection of the diagnostic modality is crucial; thus, we should be aware of basic information and approaches of the diagnostic modalities. In this review, we discuss in detail, about diagnostic modalities (radiography, CT, MRI, electrophysiologic study, and others) that are widely used for spine disease.

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Section: Central Motor Conduction Time Studymentioning

confidence: 99%

Diagnostic Modality in Spine Disease: A Review

et al. 2020

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“…Transcranial motor cortex stimulation was found more valuable in determining the localization of the lesion than MRI [45]. Anteroposterior (AP) diameter of the spinal cord, flattening at the lesion level and CMCT were well correlated [46].…”

Section: Diagnostic Tests For Csmmentioning

confidence: 99%

Cervical Spondylotic Myelopathy: Natural Course and the Value of Diagnostic Techniques –WFNS Spine Committee Recommendations

et al. 2019

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ObjectiveThis study presents the results of a systematic literature review conducted to determine most up-to-date information on the natural outcome of cervical spondylotic myelopathy (CSM) and the most reliable diagnostic techniques. MethodsA literature search was performed for articles published during the last 10 years. ResultsThe natural course of patients with cervical stenosis and signs of myelopathy is quite variable. In patients with no symptoms, but significant stenosis, the risk of developing myelopathy with cervical stenosis is approximately 3% per year. Myelopathic signs are useful for the clinical diagnosis of CSM. However, they are not highly sensitive and may be absent in approximately one-fifth of patients with myelopathy. The electrophysiological tests to be used in CSM patients are motor evoked potential (MEP), spinal cord evoked potential, somatosensory evoked potential, and electromyography (EMG). The differential diagnosis of CSM from other neurological conditions can be accomplished by those tests. MEP and EMG monitoring are useful to reduce C5 root palsy during CSM surgery. Notable spinal cord T2 hyperintensity on cervical magnetic resonance imaging (MRI) is correlated with a worse outcome, whereas lighter signal changes may predict better outcomes. T1 hypointensity should be considered a sign of more advanced disease. ConclusionThe natural course of CSM is quite variable. Signal changes on MRI and some electrophysiological tests are valuable adjuncts to diagnosis.

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“…MRI is a gold standard for CSM because it shows not only the anatomy and location of compression in the cervical spine but also intramedullary signal intensity changes in the cervical spinal cord suggestive of spinal cord lesion [23]. On the other hand, MRI reveals only morphology and not functionality of the spinal cord and MRI-driven decisions about the timing for surgery are controversial [20]. Neurophysiological techniques such as somatosensory-evoked potentials (SEP) [18] and motor-evoked potentials (MEP) may be useful tools to evaluate functionality of the cervical spinal cord [3,8,20], and a prognostic role in CSM patients referred to surgery was reported [3,19,20].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies evaluated whether clinical assessment, MRI, or MEP independently could have predicting value on surgical outcomes [3,17,20], but conclusive results are still lacking even if correlations between presurgical MRI findings, neurophysiological assessment, and surgical outcomes were found [16,20].…”

Section: Introductionmentioning

confidence: 99%

Multidimensional assessment of cervical spondylotic myelopathy patients. Usefulness of a comprehensive score system

et al. 2020

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Objective Cervical spondylotic myelopathy (CSM) is caused by cervical spine degeneration and surgery may be beneficial, but selection for surgery might be challenging. We performed a multimodal analysis to assess predicting factors that may be useful to help surgeons in this choice. Patients and methods We retrospectively evaluated clinical, motor evoked potentials (MEP), and MRI data of patients who undergone surgery for CSM. Seventy-six consecutive patients (46 males) were enrolled. The median age was 65.5 [IQR: 57–71] years, and the duration of symptoms was 11 [8–13] months. A multivariate analysis in order to assess predictors of outcome and ROC curve analysis were performed. Results Thirty patients (M:18, 39.5%) gained 6 or more points on mJOA and they were collected in good recovery group, whereas 46 patients (60.5%, M:28) showed a fair recovery. We developed a comprehensive score system (CSS) taking into account clinical, neurophysiological, and neuroradiological data. ROC curve analysis was performed to determine the discriminative power of four models derived from the multivariate logistic regression analysis for predictors of good outcome considering only clinical variables, MRI variables, and MEP variables or considering the comprehensive model, demonstrating a good accuracy of CSS model to predict outcome. Conclusion This study demonstrates that CSS model taking into consideration functional assessment by mJOA score, neurologic evaluation, cervical MRI, and MEP may be a feasible method to predict outcome in patients candidate to surgery, supporting surgeon’s decisions both for those patients candidate to surgery and for patients in whom a “wait and see” approach could be proposed.

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The relationship between central motor conduction time and spinal cord compression in patients with cervical spondylotic myelopathy

Abstract: Measurement of spinal cord compression may be useful for the evaluation of corticospinal function as a proxy for CMCT in patients with CSM.

Cited by 14 publications

References 15 publications

Diagnostic Modality in Spine Disease: A Review

Diagnostic Modality in Spine Disease: A Review

Cervical Spondylotic Myelopathy: Natural Course and the Value of Diagnostic Techniques –WFNS Spine Committee Recommendations

Multidimensional assessment of cervical spondylotic myelopathy patients. Usefulness of a comprehensive score system

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