Stenosis and Neurologic Level Discrepancies in Cervical Spondylotic Myelopathy.

Choi, YA ; Kim, K

In: PM & R : the journal of injury, function, and rehabilitation, Jg. 10 (2018-10-01), Heft 10, S. 1051-1055

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Background: Cervical spondylotic myelopathy (CSM) is the most common cause of cord dysfunction in older individuals. CSM involves either the upper motor neuron or lower motor neuron (LMN) in the cervical spine. The neurologic level of the LMN lesion does not usually correspond with the structural level detected via magnetic resonance imaging (MRI).

Objective: To examine the relationship between the structural level of stenosis and the neurologic level of LMN involvement in patients with CSM.

Design: Retrospective descriptive study.

Setting: Tertiary hospital.

Patients: Patients with cervical spondylotic myelopathy, aged 41-79 years.

Methods: We reviewed electromyography (EMG) and magnetic resonance imaging (MRI) findings from 17 patients with CSM to objectively show the relation between the structural level of stenosis and the neurologic level with LMN involvement.

Main Outcome Measurements: The structural level was defined by spinal canal stenosis with definite cord compression on MRI. The neurologic level was determined by myotomes with abnormal spontaneous activity on EMG.

Results: In all patients but one, myotomes with abnormal spontaneous EMG activity were one to 4 levels lower than the stenotic canal shown on MRI.

Conclusions: LMN involvement in CSM is usually not concordant with the structural lesion. For accurate diagnosis and treatment, physicians should recognize that myotomal involvement in CSM is often due to canal stenosis one to 4 levels above the lesion.

Level of Evidence: III.

Titel:	Stenosis and Neurologic Level Discrepancies in Cervical Spondylotic Myelopathy.
Autor/in / Beteiligte Person:	Choi, YA ; Kim, K
Link:	Full Text Finder (Volltext)
Zeitschrift:	PM & R : the journal of injury, function, and rehabilitation, Jg. 10 (2018-10-01), Heft 10, S. 1051-1055
Veröffentlichung:	2019- : [Hoboken, NJ] : Wiley ; <i>Original Publication</i>: New York, NY : Elsevier, 2018
Medientyp:	academicJournal
ISSN:	1934-1563 (electronic)
DOI:	10.1016/j.pmrj.2018.04.003
Schlagwort:	Adult Aged Cohort Studies Electromyography methods Female Humans Male Middle Aged Neurologic Examination Prognosis Retrospective Studies Risk Assessment Severity of Illness Index Spinal Cord Compression diagnostic imaging Spinal Stenosis diagnosis Spondylosis diagnosis Tertiary Care Centers Magnetic Resonance Imaging methods Spinal Cord Compression etiology Spinal Cord Compression physiopathology Spinal Stenosis complications Spondylosis complications
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [PM R] 2018 Oct; Vol. 10 (10), pp. 1051-1055. <i>Date of Electronic Publication: </i>2018 Apr 26. MeSH Terms: Magnetic Resonance Imaging / methods ; Spinal Cord Compression / etiology ; Spinal Cord Compression / physiopathology ; Spinal Stenosis / complications ; Spondylosis / *complications ; Adult ; Aged ; Cohort Studies ; Electromyography / methods ; Female ; Humans ; Male ; Middle Aged ; Neurologic Examination ; Prognosis ; Retrospective Studies ; Risk Assessment ; Severity of Illness Index ; Spinal Cord Compression / diagnostic imaging ; Spinal Stenosis / diagnosis ; Spondylosis / diagnosis ; Tertiary Care Centers Entry Date(s): Date Created: 20180430 Date Completed: 20191010 Latest Revision: 20191010 Update Code: 20231215

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