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  In cervical spondylotic myelopathy spinal cord motion is focally increased at the level of stenosis: A controlled cross-sectional study

Wolf, K., Hupp, M., Friedl, S., Sutter, R., Klarhöfer, M., Grabher, P., et al. (2018). In cervical spondylotic myelopathy spinal cord motion is focally increased at the level of stenosis: A controlled cross-sectional study. Spinal Cord, 56, 769 -776. doi:10.1038/s41393-018-0075-1.

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Item Permalink: http://hdl.handle.net/21.11116/0000-0000-D099-8 Version Permalink: http://hdl.handle.net/21.11116/0000-0003-C342-6
Genre: Journal Article


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Wolf, Katharina1, 2, Author
Hupp, Markus1, Author
Friedl, Susanne1, Author
Sutter, Reto3, Author
Klarhöfer, Markus4, Author
Grabher, Patrick1, Author
Freund, Patrick1, 5, 6, 7, Author              
Curt, Armin1, Author
1Balgrist Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland, ou_persistent22              
2Department of Neurology, University Medical Center, Freiburg, Germany, ou_persistent22              
3Department of Radiology, Balgrist University Hospital, Zurich, Switzerland, ou_persistent22              
4Siemens Healthcare AG, Zurich, Switzerland, ou_persistent22              
5Department of Brain Repair & Rehabilitation, University College London, United Kingdom, ou_persistent22              
6Wellcome Trust Centre for Neuroimaging, University College London, United Kingdom, ou_persistent22              
7Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2205649              


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 Abstract: Objectives To investigate alterations of spinal cord (SC) motion within cervical spondylotic myelopathy (CSM) across the cervical spinal segments and its relation to cerebrospinal fluid (CSF)-flow, anatomic conditions, and clinical parameters. Setting University Hospital Balgrist, Zurich, Switzerland. Methods Overall, 12 patients suffering from CSM at level C5 and 12 controls underwent cardiac-gated 2D phase-contrast-MRI at level C2 and C5 and standard MRI sequences. Parameters of interest: Velocity measurements of SC and CSF (area under the curve = total displacement (normalization for duration of the heart cycle), total displacement ratio (C5/C2; intraindividual normalization for confounders)), spinal canal diameters, clinical motor- and sensory scores, and performance measures. Results Interrater reliability was excellent for SC motion at both levels and for CSF flow at C2, but not reliable for CSF flow at C5. Within controls, SC motion at C2 positively correlated with SC motion at C5 (p = 0.000); this correlation diminished in patients (p = 0.860). SC total displacement ratio was significantly increased in patients (p = 0.029) and correlated with clinical impairment (p = 0.017). Morphometric measures of the extent of stenosis were not related to SC motion or clinical symptoms. Conclusion The findings revealed physiological interactions of CSF flow and SC motion across the cervical spine in healthy controls while being diminished in CSM patients. Findings of focally increased SC motion at the level of stenosis were related to clinical impairment and might be promising as a diagnostic and prognostic marker in CSM.


Language(s): eng - English
 Dates: 2018-01-222017-11-012018-02-012018-03-012018-08
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1038/s41393-018-0075-1
PMID: 29497178
Other: Epub 2018
 Degree: -



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Project name : -
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Funding program : Clinical Research Priority Program (CRPP)
Funding organization : University Zurich

Source 1

Title: Spinal Cord
Source Genre: Journal
Publ. Info: Basingstoke : Nature Publishing Group
Pages: - Volume / Issue: 56 Sequence Number: - Start / End Page: 769 - 776 Identifier: ISSN: 1362-4393
CoNE: https://pure.mpg.de/cone/journals/resource/1362-4393