Correlation study between clinical special tests for myelopathy and static MRI parameters in patients of Malaysian population treated for cervical dysfunction

Zakaria@Mohamad, Zamzuri and Sharifudin, Mohd Ariff and Din, Hishamudin and Abd. Aziz, Azian and Karupiah, Rajandra Kumar (2021) Correlation study between clinical special tests for myelopathy and static MRI parameters in patients of Malaysian population treated for cervical dysfunction. Cureus, 13 (10). pp. 1-14. ISSN 2168-8184

PDF (Full text article) - Published Version Restricted to Registered users only Download (686kB) | Request a copy

Abstract

Introduction: Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction. Magnetic resonance imaging (MRI) remains the imaging modality of choice, but its findings are not completely specific for clinically significant CSM. This cross-sectional study aims to determine the pathoanatomy of CSM in patients and analyze the correlations between clinical key symptoms, myelopathic signs, and MRI findings. Methods: Patients with CSM aged 30 to 80 years old with no previous cervical spine disease or injuries were recruited. Clinical parameters include myelopathic hand signs and other clinical-specific tests. The MRI findings were analyzed for level of compression, underlying degenerative pathology, and parameters for cord compression. Results: Thirty patients were recruited. The most common myelopathic signs observed were positive Hoffmann’s sign and the presence of reverse brachioradialis reflex. All patients had either degenerative or prolapse disc changes on MRI. There was a positive correlation between the clinical key features with MRI parameters for canal and cord diameter. The transverse cord diameter, cord compression ratio, and approximate cord area were the only independent variables related to almost all the positive clinical specific tests. All three have a moderate to strong correlation with the clinical findings. Conclusion: The MRI parameters such as canal and cord size of the cervical spine are an objective reflection of compression on the spinal cord. Correlations observed indicate cord compression that plays a major role in the pathophysiology of CSM. These measurements are sensitive indicators of canal stenosis and play a significant role in predicting the severity and outcome of CSM.

Item Type:	Article (Journal)
Additional Information:	3660/93294
Uncontrolled Keywords:	pathoanatomy, morphometric analysis, cord compression, cervical spondylosis, cervical spine
Subjects:	R Medicine > RD Surgery > RD701 Orthopedics
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine Kulliyyah of Medicine > Department of Department of Orthopaedics, Traumatology & Rehabilitation Kulliyyah of Medicine > Department of Radiology
Depositing User:	Professor Zamzuri Zakaria
Date Deposited:	25 Oct 2021 12:42
Last Modified:	25 Oct 2021 12:42
URI:	http://irep.iium.edu.my/id/eprint/93294

Actions (login required)

View Item