Takeshima Yasuhiro, Okamoto Ai, Yokoyama Shohei, Nishimura Fumihiko, Nakagawa Ichiro, Park Young-Soo, Nakase Hiroyuki
Department of Neurosurgery, Nara Medical University School of Medicine, Kashihara, Japan.
Neurospine. 2023 Mar;20(1):365-373. doi: 10.14245/ns.2245004.502. Epub 2023 Mar 31.
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.
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 myelopathy in each case. The patients were divided into 2 groups based on the presence or absence of rapid DCM progression, and independent risk factors were determined using logistic regression analyses.
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 significantly 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).
Facet articular irregularity is the most clinically significant finding among the known risk factors in patients with rapid DCM progression.
小关节面不规则与快速进展性退行性颈椎病（DCM）相关。然而，与其他已知危险因素相比，其意义尚不清楚。因此，本回顾性研究旨在阐明小关节面不规则作为快速进展性DCM的危险因素的潜在影响。
本研究纳入了141例在我院接受手术治疗的连续性DCM患者。收集与DCM进展相关的临床变量和影像学检查结果。对每例患者脊髓病节段水平的影像学表现进行分析。根据是否存在快速DCM进展将患者分为两组，并采用逻辑回归分析确定独立危险因素。
总体分析了131例平均年龄为63.9±12.6岁的患者；27例（20.
