316 Magnetic Resonance Imaging Analysis of the Combined AOSpine North America and International Studies, Part I: The Prevalence and Spectrum of Pathologies in a Global Cohort of Patients With Degenerative Cervical Myelopathy

Aria Nouri, Allan R. Martin, Lindsay Tetreault, Anick Nater, So Kato, Hiroaki Nakashima, Narihito Nagoshi, Hamed Reihani-Kermani, Michael G. Fehlings

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

INTRODUCTION: Degenerative cervical myelopathy (DCM) encompasses a spectrum of age-related conditions that result in progressive spinal cord injury through static and dynamic injury mechanisms. Through detailed review of MRIs from prospective AOSpine multicenter studies, the global prevalence of degenerative cervical pathologies of surgically treated DCM patients is reported.

METHODS: MRIs of 458 patients were obtained from North America (n = 197), Europe (n = 92), Latin America (n = 57), and Asia-Pacific (n = 112) and assessed for the type of pathology, source of stenosis, level of maximum cord compression, levels of spinal cord compression (SCC), presence of signal changes on T2-weighted images (T2WI) and T1-weighted images, and the levels of T2WI signal change. The proportion of degenerative changes present alongside other diagnoses was computed as well as the prevalence of pathologies per geographical region. The prevalence of degenerative changes was separated by sex and assessed using χ analysis.

RESULTS: Spondylosis was the most frequent cause of SCC (89.7%) and it was frequently accompanied by enlargement of the ligamentum flavum (59.85%). Ossification of the posterior longitudinal ligament (OPLL) was accompanied by spondylosis in 91.7%. Single-level disc pathology, OPLL, and spondylolisthesis had a prevalence of ∼10%. Klippel-Feil syndrome was observed in 2.8%. Single-level pathology was less common in North America, and OPLL was more common and spondylolisthesis less common in Asia-Pacific. Females presented more commonly with single-level disc pathology (P = .013), and males with spondylosis (P = .017) and enlargement of ligamentum flavum (P = .012). Globally, C5-6 was the most frequent maximum compressed site (39.7%) and region for T2WI hyperintensity (38.9%). T2WI hyperintensity more commonly presented in males (P < .001).

CONCLUSION: DCM pathologies, including OPLL, are highly interrelated and rarely present in isolation. Females presented with milder evidence of DCM on MRI. There are also variances in the spectrum and prevalence of pathologies between geographical regions and these may be due to a multitude of causes.

Original languageEnglish
Pages (from-to)191-192
Number of pages2
JournalNeurosurgery
Volume63
DOIs
Publication statusPublished - 2016 Aug 1
Externally publishedYes

Fingerprint

Spinal Cord Diseases
North America
Ossification of Posterior Longitudinal Ligament
Pathology
Spondylosis
Ligamentum Flavum
Spondylolisthesis
Spinal Cord Compression
Klippel-Feil Syndrome
Latin America
Spinal Cord Injuries
Multicenter Studies
Pathologic Constriction
Wounds and Injuries

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

316 Magnetic Resonance Imaging Analysis of the Combined AOSpine North America and International Studies, Part I : The Prevalence and Spectrum of Pathologies in a Global Cohort of Patients With Degenerative Cervical Myelopathy. / Nouri, Aria; Martin, Allan R.; Tetreault, Lindsay; Nater, Anick; Kato, So; Nakashima, Hiroaki; Nagoshi, Narihito; Reihani-Kermani, Hamed; Fehlings, Michael G.

In: Neurosurgery, Vol. 63, 01.08.2016, p. 191-192.

Research output: Contribution to journalArticle

Nouri, Aria ; Martin, Allan R. ; Tetreault, Lindsay ; Nater, Anick ; Kato, So ; Nakashima, Hiroaki ; Nagoshi, Narihito ; Reihani-Kermani, Hamed ; Fehlings, Michael G. / 316 Magnetic Resonance Imaging Analysis of the Combined AOSpine North America and International Studies, Part I : The Prevalence and Spectrum of Pathologies in a Global Cohort of Patients With Degenerative Cervical Myelopathy. In: Neurosurgery. 2016 ; Vol. 63. pp. 191-192.
@article{f153c2aa861045c98380d7e00341c491,
title = "316 Magnetic Resonance Imaging Analysis of the Combined AOSpine North America and International Studies, Part I: The Prevalence and Spectrum of Pathologies in a Global Cohort of Patients With Degenerative Cervical Myelopathy",
abstract = "INTRODUCTION: Degenerative cervical myelopathy (DCM) encompasses a spectrum of age-related conditions that result in progressive spinal cord injury through static and dynamic injury mechanisms. Through detailed review of MRIs from prospective AOSpine multicenter studies, the global prevalence of degenerative cervical pathologies of surgically treated DCM patients is reported.METHODS: MRIs of 458 patients were obtained from North America (n = 197), Europe (n = 92), Latin America (n = 57), and Asia-Pacific (n = 112) and assessed for the type of pathology, source of stenosis, level of maximum cord compression, levels of spinal cord compression (SCC), presence of signal changes on T2-weighted images (T2WI) and T1-weighted images, and the levels of T2WI signal change. The proportion of degenerative changes present alongside other diagnoses was computed as well as the prevalence of pathologies per geographical region. The prevalence of degenerative changes was separated by sex and assessed using χ analysis.RESULTS: Spondylosis was the most frequent cause of SCC (89.7{\%}) and it was frequently accompanied by enlargement of the ligamentum flavum (59.85{\%}). Ossification of the posterior longitudinal ligament (OPLL) was accompanied by spondylosis in 91.7{\%}. Single-level disc pathology, OPLL, and spondylolisthesis had a prevalence of ∼10{\%}. Klippel-Feil syndrome was observed in 2.8{\%}. Single-level pathology was less common in North America, and OPLL was more common and spondylolisthesis less common in Asia-Pacific. Females presented more commonly with single-level disc pathology (P = .013), and males with spondylosis (P = .017) and enlargement of ligamentum flavum (P = .012). Globally, C5-6 was the most frequent maximum compressed site (39.7{\%}) and region for T2WI hyperintensity (38.9{\%}). T2WI hyperintensity more commonly presented in males (P < .001).CONCLUSION: DCM pathologies, including OPLL, are highly interrelated and rarely present in isolation. Females presented with milder evidence of DCM on MRI. There are also variances in the spectrum and prevalence of pathologies between geographical regions and these may be due to a multitude of causes.",
author = "Aria Nouri and Martin, {Allan R.} and Lindsay Tetreault and Anick Nater and So Kato and Hiroaki Nakashima and Narihito Nagoshi and Hamed Reihani-Kermani and Fehlings, {Michael G.}",
year = "2016",
month = "8",
day = "1",
doi = "10.1227/01.neu.0000489805.22111.aa",
language = "English",
volume = "63",
pages = "191--192",
journal = "Neurosurgery",
issn = "0148-396X",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - 316 Magnetic Resonance Imaging Analysis of the Combined AOSpine North America and International Studies, Part I

T2 - The Prevalence and Spectrum of Pathologies in a Global Cohort of Patients With Degenerative Cervical Myelopathy

AU - Nouri, Aria

AU - Martin, Allan R.

AU - Tetreault, Lindsay

AU - Nater, Anick

AU - Kato, So

AU - Nakashima, Hiroaki

AU - Nagoshi, Narihito

AU - Reihani-Kermani, Hamed

AU - Fehlings, Michael G.

PY - 2016/8/1

Y1 - 2016/8/1

N2 - INTRODUCTION: Degenerative cervical myelopathy (DCM) encompasses a spectrum of age-related conditions that result in progressive spinal cord injury through static and dynamic injury mechanisms. Through detailed review of MRIs from prospective AOSpine multicenter studies, the global prevalence of degenerative cervical pathologies of surgically treated DCM patients is reported.METHODS: MRIs of 458 patients were obtained from North America (n = 197), Europe (n = 92), Latin America (n = 57), and Asia-Pacific (n = 112) and assessed for the type of pathology, source of stenosis, level of maximum cord compression, levels of spinal cord compression (SCC), presence of signal changes on T2-weighted images (T2WI) and T1-weighted images, and the levels of T2WI signal change. The proportion of degenerative changes present alongside other diagnoses was computed as well as the prevalence of pathologies per geographical region. The prevalence of degenerative changes was separated by sex and assessed using χ analysis.RESULTS: Spondylosis was the most frequent cause of SCC (89.7%) and it was frequently accompanied by enlargement of the ligamentum flavum (59.85%). Ossification of the posterior longitudinal ligament (OPLL) was accompanied by spondylosis in 91.7%. Single-level disc pathology, OPLL, and spondylolisthesis had a prevalence of ∼10%. Klippel-Feil syndrome was observed in 2.8%. Single-level pathology was less common in North America, and OPLL was more common and spondylolisthesis less common in Asia-Pacific. Females presented more commonly with single-level disc pathology (P = .013), and males with spondylosis (P = .017) and enlargement of ligamentum flavum (P = .012). Globally, C5-6 was the most frequent maximum compressed site (39.7%) and region for T2WI hyperintensity (38.9%). T2WI hyperintensity more commonly presented in males (P < .001).CONCLUSION: DCM pathologies, including OPLL, are highly interrelated and rarely present in isolation. Females presented with milder evidence of DCM on MRI. There are also variances in the spectrum and prevalence of pathologies between geographical regions and these may be due to a multitude of causes.

AB - INTRODUCTION: Degenerative cervical myelopathy (DCM) encompasses a spectrum of age-related conditions that result in progressive spinal cord injury through static and dynamic injury mechanisms. Through detailed review of MRIs from prospective AOSpine multicenter studies, the global prevalence of degenerative cervical pathologies of surgically treated DCM patients is reported.METHODS: MRIs of 458 patients were obtained from North America (n = 197), Europe (n = 92), Latin America (n = 57), and Asia-Pacific (n = 112) and assessed for the type of pathology, source of stenosis, level of maximum cord compression, levels of spinal cord compression (SCC), presence of signal changes on T2-weighted images (T2WI) and T1-weighted images, and the levels of T2WI signal change. The proportion of degenerative changes present alongside other diagnoses was computed as well as the prevalence of pathologies per geographical region. The prevalence of degenerative changes was separated by sex and assessed using χ analysis.RESULTS: Spondylosis was the most frequent cause of SCC (89.7%) and it was frequently accompanied by enlargement of the ligamentum flavum (59.85%). Ossification of the posterior longitudinal ligament (OPLL) was accompanied by spondylosis in 91.7%. Single-level disc pathology, OPLL, and spondylolisthesis had a prevalence of ∼10%. Klippel-Feil syndrome was observed in 2.8%. Single-level pathology was less common in North America, and OPLL was more common and spondylolisthesis less common in Asia-Pacific. Females presented more commonly with single-level disc pathology (P = .013), and males with spondylosis (P = .017) and enlargement of ligamentum flavum (P = .012). Globally, C5-6 was the most frequent maximum compressed site (39.7%) and region for T2WI hyperintensity (38.9%). T2WI hyperintensity more commonly presented in males (P < .001).CONCLUSION: DCM pathologies, including OPLL, are highly interrelated and rarely present in isolation. Females presented with milder evidence of DCM on MRI. There are also variances in the spectrum and prevalence of pathologies between geographical regions and these may be due to a multitude of causes.

UR - http://www.scopus.com/inward/record.url?scp=85032801634&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032801634&partnerID=8YFLogxK

U2 - 10.1227/01.neu.0000489805.22111.aa

DO - 10.1227/01.neu.0000489805.22111.aa

M3 - Article

C2 - 27399514

AN - SCOPUS:85032801634

VL - 63

SP - 191

EP - 192

JO - Neurosurgery

JF - Neurosurgery

SN - 0148-396X

ER -