Narrowing Of Cervical Spinal Canal Research Articles

The Functional Outcome of Multisegmental Cervical Myelopathy Treated by Anterior Cervical Surgery

Background: Cervical spondylosis is a degenerative condition in which there is narrowing of cervical spinal canal and neural foramina secondarily due to multifactorial degenerative changes. In cervical spondylotic myelopathy there is spinal cord dysfunction. The degenerative changes cause reduction in disc height, facetalarthosis, motion abnormality, spur formation which leads to compression of the cervical spinal cord. Methods: In this prospective study 40 patients of cervical myelopathy radiculopathy and myeloradiculopathy were included in the study. After doing the anterior cervical surgery in Multisegmental Cervical Myelopathy, postoperatively all the patients were assessed for the functional outcome using MJOAss at postoperative interval of one month, three months and six months. Results: Mild, moderate and severe MJOAss (postoperative) at 6 months was present in 87.5%, 10% and 2.5% of the study population respectively. Hoarseness of voice (10%) was the most common complication followed by dysphagia (5%), graft site infection (2.5%) and myocardial infarction (2.5%) amongst the study population. Conclusion: Surgery is preferred in clinically evident Cervical Spondylotic Myelopathy patients. The decision of surgery is made on the basis of disability duration, symptoms and cervical spinal stenosis which are outweighted to the risk of operative intervention. The purpose of surgery is to decompress the spinal cord and stabilise the spinal column.

A practical radiographic visual estimation technique for the prediction of developmental narrowing of cervical spinal canal

To determine if visual spinal canal percentage of facet overlap could be used as a rapid visual pre-screening test to detect developmental bony spinal canal narrowing on lateral cervical radiographs. Lateral cervical spine radiographs with radiology report documenting developmental narrowing of the spine canal were retrospectively identified. Cohort was supplemented with additional images without such documentation. Utilizing a radiology work station, one reader (Orthopaedics) calculated the Torg ratio at C3-C6. Two readers (Radiology, Primary Care Sports Medicine) visually estimated percentage (≥80, ≥90, 100%) of spinal canal overlaid by facet articulations C3-C6 for all cases independently. Statistical analysis included accuracy tests and kappa test for comparing the gold standard and inter-, intra-observer reliability, respectively. 96 lateral images were included; 25 had abnormal radiology reports. High specificity (range, 91-93%) and true negative predictive values (range, 88-93%) achieved consistent statistical significance for relationship between facet/canal overlap and Torg ratio for both combined and individual data points. Sensitivity values (range, 59-75%) showed a trend toward association, with statistical significance for only the C3 level at 80% overlap. Interobserver agreement was substantial. Intra-observer reliability was moderate to perfect. Visual estimation of percentage of facet overlap of the spinal canal is a valid tool to identify individuals with potential developmental narrowing of the spinal canal as a screening prompt to select which patients may need formal calculation utilizing accepted metrics. Advances in knowledge Visual estimation of percentage of facet overlap from lateral radiographs can predict developmental narrowing of cervical spinal canal.