Asymptomatic cervical cord compression in lumbar spinal stenosis patients: a whole spine magnetic resonance imaging study.

STUDY

DESIGN

A retrospective study.

OBJECTIVE

To analyze incidence of asymptomatic cervical cord compression and related factors in lumbar stenosis patients.

SUMMARY OF BACKGROUND DATA: Neural compression resulted from degenerative disc is not unusual in the asymptomatic cervical spine. However, its incidence and clinically related factors in lumbar stenosis patients have not been studied.

METHODS

We analyzed lumbar stenosis index (LSI), cervical cord compression index (CCI), and Torg-Pavlov ratio of whole spine magnetic resonance images of 93 lumbar stenosis patients. We compared lumbar stenosis involving a single segment versus multiple segments in the cases with the LSI of double-level or more, patients in 60s versus in 70s, and male versus female for the above variables.

RESULTS

Of total 93 cases, 71 cases did not demonstrate cervical cord compression, but moderate or severe cervical cord compression was observed in 22 cases (23.7%). The multiple segment lumbar stenosis group, the 70s group, and male group had statistically significant higher CCI. The correlation coefficient between the CCI and the LSI indicated a strong positive linear relationship with 0.54 (P = 0).

CONCLUSION

Moderate or severe cervical cord compression was observed in 24% of lumbar stenosis patients. Asymptomatic cervical cord compression is more likely to be developed in lumbar stenosis patients who are aged, male, and involving multiple segments. These factors should be considered for management of lumbar stenosis patients.