Morgado Alexis, Berthiller Julien, Subtil Fabien, Creatura Donato, Patet Gildas, André-Obadia Nathalie, Barrey Cédric Yves
Department of Spine and Spinal Cord Surgery, Hôpital Pierre Wertheimer, Hospices Civils de Lyon, Claude Bernard University of Lyon 1, 59 Boulevard Pinel, 69003 Lyon, France.
Service de Biostatistique, Hospices Civils de Lyon, 69003 Lyon, France.
Brain Sci. 2025 May 23;15(6):557. doi: 10.3390/brainsci15060557.
Degenerative cervical myelopathy (DCM) is the leading cause of functional disabilities of spinal origin in people over 50 years old. The objective of the present study was to establish a multi-parametric weighted scoring system that is easy to use in daily practice, based on the most significant MRI signs and correlated as strongly as possible with the clinical presentation (mJOA)-we call this system the SIMS or Severity on Imaging Myelopathy Score. : Ninety-nine patients who underwent clinical and radiological evaluation by mJOA and MRI between January 2015 and March 2021 were retrospectively included. The variables included in the score were the Fujiwara ratio, the T2-weighted intramedullary hyperintensity, the aspect of the peri-medullary fluid cisterns, the Torg-Pavlov ratio, the local kyphosis and the number of stenotic levels. Each variable was first correlated to the mJOA score for each patient, making it possible to construct the final SIMS at the end, and validate it by comparison with mJOA scores. : The variables that were significantly correlated with one another were the T2-weighted intramedullary hyperintensity, the reduction in peri-medullary fluid spaces and the number of stenotic levels ( < 0.05). Then, points were assigned to each variable according to their relative importance and made it possible to construct the definitive SIMS. The final Spearman correlation coefficient between the SIMS and the mJOA score was -0.747. : This work showed that this new multi-parametric MRI-based scoring system represents a consistent means to characterize the degree of severity of degenerative cervical myelopathy.
退行性颈椎脊髓病（DCM）是50岁以上人群脊髓源性功能障碍的主要原因。本研究的目的是基于最显著的MRI征象建立一种易于在日常实践中使用的多参数加权评分系统，并使其与临床表现（改良日本骨科学会评分，mJOA）尽可能紧密相关——我们将这个系统称为SIMS或影像脊髓病严重程度评分。回顾性纳入了199例在2015年1月至2021年3月期间接受mJOA和MRI临床及影像学评估的患者。该评分系统纳入的变量包括藤原比率、T2加权像上的脊髓内高信号、脊髓周围脑脊液池的形态、Torg-Pavlov比率、局部后凸以及狭窄节段数。首先将每个变量与每位患者的mJOA评分进行关联，最终构建出最终的SIMS，并通过与mJOA评分进行比较来验证。彼此显著相关的变量为T2加权像上的脊髓内高信号、脊髓周围脑脊液间隙减小以及狭窄节段数（<0.05）。然后，根据每个变量的相对重要性进行赋分，从而构建出最终的SIMS。SIMS与mJOA评分之间的最终Spearman相关系数为-0.747。这项研究表明，这种基于MRI的新多参数评分系统是一种用于描述退行性颈椎脊髓病严重程度的可靠方法。
