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Does lumbar spinal stenosis increase the risk of spondylotic cervical spinal cord compression?

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Abstract

Purpose

The aim of this prospective cross-sectional observational comparative study was to determine the prevalence of spondylotic cervical cord compression (SCCC) and symptomatic cervical spondylotic myelopathy (CSM) in patients with symptomatic lumbar spinal stenosis (LSS) in comparison with a general population sample and to seek to identify predictors for the development of CSM.

Methods

A group of 78 patients with LSS (48 men, median age 66 years) was compared with a randomly selected age- and sex-matched group of 78 volunteers (38 men, median age 66 years). We evaluated magnetic resonance imaging findings from the cervical spine and neurological examination.

Results

The presence of SCCC was demonstrated in 84.6 % of patients with LSS, but also in 57.7 % of a sample of volunteers randomly recruited from the general population. Clinically symptomatic CSM was found in 16.7 % of LSS patients in comparison with 1.3 % of volunteers (p = 0.001). Multivariable logistic regression proposed the Oswestry Disability Index of 43 % or more as the only independent predictor of symptomatic CSM in LSS patients (OR 9.41, p = 0.008).

Conclusions

The presence of symptomatic LSS increases the risk of SCCC; the prevalence of SCCC is higher in patients with symptomatic LSS in comparison with the general population, with an evident predominance of more serious types of MRI-detected compression and a clinically symptomatic form (CSM). Symptomatic CSM is more likely in LSS patients with higher disability as assessed by the Oswestry Disability Index.

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Abbreviations

ASCCC:

Asymptomatic spondylotic cervical cord compression

CSM:

Cervical spondylotic myelopathy

CSR:

Cervical spondylotic radiculopathy

LSS:

Lumbar spinal stenosis

MRI:

Magnetic resonance imaging

ODI:

Oswestry Disability Index

OR:

Odds ratio

ROC:

Receiver operating characteristic

SCCC:

Spondylotic cervical cord compression

References

  1. Epstein NE, Epstein JA, Carras R, Murthy VS, Hyman RA (1984) Coexisting cervical and lumbar spinal stenosis: diagnosis and management. Neurosurgery 15:489–496

    Article  CAS  PubMed  Google Scholar 

  2. Dagi TF, Tarkington MA, Leech JJ (1987) Tandem lumbar and cervical spinal stenosis. Natural history, prognostic indices, and results after surgical decompression. J Neurosurg 66:842–849

    Article  CAS  PubMed  Google Scholar 

  3. Lee MJ, Garcia R, Cassinelli EH, Furey C, Riew KD (2008) Tandem stenosis: a cadaveric study in osseous morphology. Spine J 8:1003–1006

    Article  PubMed  Google Scholar 

  4. Bajwa NS, Toy JO, Young EY, Ahn NU (2012) Is congenital bony stenosis of the cervical spine associated with lumbar spine stenosis? An anatomical study of 1072 human cadaveric specimens. J Neurosurg Spine 17:24–29

    Article  PubMed  Google Scholar 

  5. Matsumoto M, Okada E, Toyama Y, Fujiwara H, Momoshima S, Takahata T (2013) Tandem age-related lumbar and cervical intervertebral disc changes in asymptomatic subjects. Eur Spine J 22:708–713

    Article  PubMed Central  PubMed  Google Scholar 

  6. Aydogan M, Ozturk C, Mirzanli C, Karatoprak O, Tezer M, Hamzaoglu A (2007) Treatment approach in tandem (concurrent) cervical and lumbar spinal stenosis. Acta Orthop Belg 73:234–237

    PubMed  Google Scholar 

  7. Lee SH, Kim KT, Suk KS, Lee JH, Shin JH, So DH, Kwack YH (2010) Asymptomatic cervical cord compression in lumbar spinal stenosis patients: a whole spine magnetic resonance imaging study. Spine 35:2057–2063

    PubMed  Google Scholar 

  8. Bennett S, Woods T, Liyanage WM, Smith DL (1991) A simplified general method for cluster-sample surveys of health in developing countries. World Health Stat Q 44:98–106

    CAS  PubMed  Google Scholar 

  9. Shimomura T, Sumi M, Nishida K, Maeno K, Tadokoro K, Miyamoto H, Kurosaka M, Doita M (2007) Prognostic factors for deterioration of patients with cervical spondylotic myelopathy after nonsurgical treatment. Spine 32:2474–2479

    Article  PubMed  Google Scholar 

  10. Teresi LM, Lufkin RB, Reicher MA, Moffit BJ, Vinuela FV, Wilson GM, Bentson JR, Hanafee WN (1987) Asymptomatic degenerative disk disease and spondylosis of the cervical spine: MR imaging. Radiology 164:83–88

    Article  CAS  PubMed  Google Scholar 

  11. Yu YL, Stevens JM, Kendall B, du Boulay GH (1983) Cord shape and measurements in cervical spondylotic myelopathy and radiculopathy. Am J Neuroradiol 4:839–842

    CAS  PubMed  Google Scholar 

  12. Kim BS, Kim J, Koh HS, Han SY, Lee DY, Kim KH (2010) Asymptomatic cervical or thoracic lesions in elderly patients who have undergone decompressive lumbar surgery for stenosis. Asian Spine J 4:65–70

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Kang Y, Lee JW, Koh YH, Hur S, Kim SJ, Chai JW, Kang HS (2011) New MRI grading system for the cervical canal stenosis. Am J Roentgenol 197:W134–W140

    Article  Google Scholar 

  14. Adamova B, Bednarik J, Smardova L, Moravcova E, Chvatalova N, Prokes B, Kadanka Z (2000) Association between cervical and lumbar stenosis of the spinal canal. Cesk Slov Neurol N 63:261–267

    Google Scholar 

Download references

Acknowledgments

This study was supported by Grant project NT-13449-4 of the Internal Grant Agency of the Ministry of Health of the Czech Republic and by Ministry of Health, Czech Republic-conceptual development of research organization (FNBr, 65269705).

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Correspondence to Blanka Adamova.

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Adamova, B., Bednarik, J., Andrasinova, T. et al. Does lumbar spinal stenosis increase the risk of spondylotic cervical spinal cord compression?. Eur Spine J 24, 2946–2953 (2015). https://doi.org/10.1007/s00586-015-4049-0

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  • DOI: https://doi.org/10.1007/s00586-015-4049-0

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