Facet Articular Irregularity Is the Most Relevant Risk Factor for Rapidly Progressive Degenerative Cervical Myelopathy

Yasuhiro Takeshima; Ai Okamoto; Shohei Yokoyama; Fumihiko Nishimura; Ichiro Nakagawa; Young-Soo Park; Hiroyuki Nakase

doi:10.14245/ns.2245004.502

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자료유형: 학술저널

저자정보: Yasuhiro Takeshima (Department of Neurosurgery Nara Medical University School of Medicine) Ai Okamoto (Department of Neurosurgery Nara Medical University School of Medicine) Shohei Yokoyama (Department of Neurosurgery Nara Medical University School of Medicine) Fumihiko Nishimura (Department of Neurosurgery Nara Medical University School of Medicine) Ichiro Nakagawa (Department of Neurosurgery Nara Medical University School of Medicine) Young-Soo Park (Department of Neurosurgery Nara Medical University School of Medicine) Hiroyuki Nakase (Department of Neurosurgery Nara Medical University School of Medicine)

저널정보: 대한척추신경외과학회 Neurospine Neurospine 제20권 제1호

발행연도: 2023.3

수록면: 365 - 373 (9page)

DOI: 10.14245/ns.2245004.502

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Objective: Facet articular irregularity is associated with rapidly progressive degenerative cervical myelopathy (DCM). However, its significance compared with other known risk factors remains unknown. Therefore, this retrospective study aimed to clarify the potential impact of facet articular irregularity as a risk factor for rapid DCM progression. Methods: This study included 141 consecutive patients with DCM who underwent surgical treatment at our institution. Clinical variables and radiological findings related to DCM progression were collected. Imaging findings were analyzed at the segmental level of my elopathy in each case. The patients were divided into 2 groups based on the presence or ab sence of rapid DCM progression, and independent risk factors were determined using lo gistic regression analyses. Results: Overall, 131 patients with a mean age of 63.9 ± 12.6 years were analyzed; 27 patients (20.6%) were classified into the rapid DCM progression group. The mean age was signifi cantly higher in the rapid progression group than in the slow progression group (72.4 ± 9.6 vs. 61.7 ± 12.4, p < 0.001). According to univariate analysis, facet articular irregularity, dynamic segmental translation (≥ 1.6 mm), upper cervical spine involvement above C4–5, history of cerebrovascular events, preceding minor trauma, local lordotic angle (≥ 4.5°), diabetes, hypertension, ligamentum flavum hypertrophy, and age were independent risk factors. Additionally, multivariate analysis showed that facet articular irregularity was the highest risk factor for rapid DCM progression (p = 0.001). Conclusion: Facet articular irregularity is the most clinically significant finding among the known risk factors in patients with rapid DCM progression.

#Articular #Cervical myelopathy #Degenerative #Facet joint #Logistic regression #Risk factor

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Yasuhiro Takeshima

소속기관 Department of Neurosurgery, Nara Medical University

주요연구분야 의약학 > 임상의학 > 신경외과학

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Ai Okamoto