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

• Published in: World neurosurgery Vol. 130; pp. e709 - e714
• Main Authors: Yuk, Chang Duk, Kim, Tae Hwan, Park, Moon Soo, Kim, Seok Woo, Chang, Ho Geun, Kim, Ji Hee, Ahn, Jun Hyong, Chang, In Bok, Song, Joon Ho, Oh, Jae Keun
• Format: Journal Article
• Language: English
• Published: United States 01.10.2019
• Subjects: Aged; Aged, 80 and over; Cervical Cord - diagnostic imaging; Cervical Cord - surgery; Cervical Vertebrae - diagnostic imaging; Cervical Vertebrae - surgery; Female; Humans; Magnetic Resonance Imaging - methods; Male; Middle Aged; Random Allocation; Retrospective Studies; Spinal Cord Compression - diagnostic imaging; Spinal Cord Compression - surgery; Spinal Diseases - diagnostic imaging; Spinal Diseases - surgery; Whole spine sagittal balance; Cervical cord compression index; Sagittal vertical axis; Whole spine sagittal T2 scout magnetic resonance imaging
• ISSN: 1878-8750; 1878-8769
• DOI: 10.1016/j.wneu.2019.06.198

We sought to investigate the relationship between cervical cord compression and factors related to whole-spine sagittal balance. This retrospective single-center 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. 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). 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.