Nakashima Hiroaki, Kawakami Noriaki, Ohara Tetsuya, Saito Toshiki, Tauchi Ryoji, Imagama Shiro
Meijo Hospital, Nagoya, Japan.
Nagoya University Graduate School of Medicine, Nagoya, Japan.
Global Spine J. 2023 Jul;13(6):1576-1581. doi: 10.1177/21925682211041979. Epub 2021 Sep 8.
Retrospective cohort study.
The aim was to examine cervical spinal cord compression (SCC) in adult scoliosis and clarify the prevalence of and risk factors for cervical SCC.
This study included 270 adult scoliosis patients and 1211 healthy volunteers. Cervical SCC was evaluated on cervical magnetic resonance imaging (MRI). The rates of SCC for those with adult scoliosis and the healthy volunteers were compared. Logistic regression analysis was conducted to examine the factors associated with cervical SCC on MRI.
In cases with adult scoliosis, preoperative major scoliosis curve was 56.0° ± 18.8°, and cervical SCC was detected in 25 patients (9.3%). Among the healthy volunteers, 64 cases with cervical SCC were detected. Only in cases with adult scoliosis, logistic regression analysis revealed higher age (OR 1.09, 95% CI 1.04-1.14, < .001), narrow canal diameter (OR 2.27, 95% CI 1.35-3.85, = .002), and inferior sagittal balance (OR 2.45, 95% CI 1.02-5.89, = .04) as significant risk factors. In the logistic regression analysis in all subjects (including adult scoliosis and healthy volunteers), higher age (OR 1.08, 95% CI 1.06-1.10, < .001) and narrow canal diameter (OR 1.62, 95% CI 1.37-1.92, < .001) were also found to be significant risk factors, but the presence of scoliosis was not a significant factor.
Adult scoliosis itself was not significantly associated with cervical SCC. Inferior sagittal balance in addition to scoliosis constituted a significant risk factor for cervical SCC.
回顾性队列研究。
旨在研究成人脊柱侧弯患者的颈脊髓受压情况，并阐明颈脊髓受压的患病率及危险因素。
本研究纳入了270例成人脊柱侧弯患者和1211名健康志愿者。通过颈椎磁共振成像（MRI）评估颈脊髓受压情况。比较成人脊柱侧弯患者和健康志愿者的脊髓受压率。进行逻辑回归分析以研究MRI上与颈脊髓受压相关的因素。
在成人脊柱侧弯患者中，术前主要脊柱侧弯角度为56.0°±18.8°，25例（9.3%）患者检测到颈脊髓受压。在健康志愿者中，检测到64例颈脊髓受压。仅在成人脊柱侧弯患者中，逻辑回归分析显示年龄较大（比值比1.09，95%置信区间1.04 - 1.14，P <.001）、椎管直径狭窄（比值比2.27，95%置信区间1.35 - 3.85，P =.002）和矢状面平衡差（比值比2.45，95%置信区间1.02 - 5.89，P =.04）是显著的危险因素。在所有受试者（包括成人脊柱侧弯患者和健康志愿者）的逻辑回归分析中，年龄较大（比值比1.08，95%置信区间1.06 - 1.10，P <.001）和椎管直径狭窄（比值比1.62，95%置信区间1.37 - 1.92，P <.001）也被发现是显著的危险因素，但脊柱侧弯的存在不是显著因素。
成人脊柱侧弯本身与颈脊髓受压无显著相关性。除脊柱侧弯外，矢状面平衡差是颈脊髓受压的重要危险因素。
