Cervical Cord Compression and Whole-Spine Sagittal Balance

Cervical Cord Compression and Whole-Spine Sagittal Balance: Retrospective Study Using Whole-Spine Magnetic Resonance Imaging and Cervical Cord Compression Index.

Published: World Neurosurg. 2019 Oct;130:e709-e714. doi: 10.1016/j.wneu.2019.06.198. Epub 2019 Jul 4.

Referenced in Pub Med:

Authors: Yuk CD1, Kim TH2, Park MS2, Kim SW2, Chang HG2, Kim JH1, Ahn JH1, Chang IB1, Song JH1, Oh JK3.

  • Department of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
  • Department of Orthopedics, Hallym University Sacred Heart Hospital, Anyang, Korea.
  • Department of Neurosurgery, Hallym University Sacred Heart Hospital, Anyang, Korea.

OBJECTIVE: We sought to investigate the relationship between cervical cord compression and factors related to whole-spine sagittal balance.

METHODS: This retrospective single-centre study included patients who visited our clinic for the evaluation of lumbar pathology including trauma and degeneration.

Patients aged 60-89 years who underwent whole-spine sagittal T2 scout magnetic resonance imaging and whole-spine radiograph between 2014 and 2018 were included in our study.

We consecutively enrolled 100 patients for our study without any prejudice. We collected data on patient characteristics, diagnosis, cervical cord compression index (CCI), sagittal vertical axis (C7-S1, C2-7), and other parameters related to sagittal balance such as pelvic incidence minus lumbar lordosis.

Pearson correlation coefficients were calculated to compare CCI with each whole-spine sagittal balance parameter.
RESULTS: Of the 100 patients, 44 were men. The mean age was 74.21 years. On the basis of Pearson correlation coefficients, CCI showed the strongest positive linear correlation with C7-S1 sagittal vertical axis (r = 0.688; P < 0.01), followed by the C2-7 sagittal vertical axis (r = 0.563; P < 0.01).
CONCLUSIONS: Cervical cord compression is more likely to develop in patients with sagittal imbalance. It is important to use whole-spine radiograph and whole-spine T2 scout magnetic resonance imaging to analyze CCI in these patients.

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