Stress distribution of the spinal cord and clinical relevance in cervical spondylotic myelopathy

Kohei Takahashi, Hiroshi Ozawa, Naoya Sakamoto, Yuka Minegishi, Masaaki Sato, Eiji Itoi

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Intramedullary stress Intramedullary stress was analyzed in patients with cervical spondylotic myelopathy cervical spondylotic myelopathy (CSM) using a finite element method (FEM). A total of 99 disc levels of 30 patients with CSM were analyzed and divided into two groups: 33 disc levels with high signal intensity (HSI) on T2WI MRI (HSI group) and 66 disc levels without HSI (non-HSI group). Ninety disc levels of 30 patients without myelopathy were set up as a control group. The stress in the HSI group was significantly highest among three groups. The cutoff value to present HSI was 2.30 kPa from a receiver operator characteristics (ROC) analysis. A multiple logistic regression analysis was performed to compare the utility of the three parameters as prognosticators for the onset of myelopathy: intramedullary stress, the cross-sectional area of the spinal cord, and the anteroposterior compression ratio (APCR). Intramedullary stress had the highest odds ratio. The intramedullary stress significantly reduced after surgery. From the analysis of the correlation between the local kyphosis angle and the reduction of the stress after surgery in HSI group, the higher the kyphosis was, the less the reduction of the stress after surgery. In conclusion, intramedullary stress reflected clinical manifestations in patients with CSM.

Original languageEnglish
Title of host publicationNeuroprotection and Regeneration of the Spinal Cord
PublisherSpringer Japan
Pages311-321
Number of pages11
Volume9784431545026
ISBN (Electronic)9784431545026
ISBN (Print)4431545018, 9784431545019
DOIs
Publication statusPublished - 2014 Nov 1

Keywords

  • Cervical spondylotic myelopathy
  • Finite element method
  • Intramedullary stress

ASJC Scopus subject areas

  • Medicine(all)

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    Takahashi, K., Ozawa, H., Sakamoto, N., Minegishi, Y., Sato, M., & Itoi, E. (2014). Stress distribution of the spinal cord and clinical relevance in cervical spondylotic myelopathy. In Neuroprotection and Regeneration of the Spinal Cord (Vol. 9784431545026, pp. 311-321). Springer Japan. https://doi.org/10.1007/978-4-431-54502-6_25