Multiple sclerosis and related disorders · 2026
Association between cervical spinal cord plaque length and adjacent degenerative cervical changes in multiple sclerosis: a cross-sectional MRI study.
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Jahanshahi Amirreza, Hosseini Samaneh, Azar Sepehr Mahmoudi, Ghannadi Mina, Rezazadeh Khatereh
Аннотация
OBJECTIVE: To evaluate the association between cervical spinal cord demyelinating plaque length and adjacent degenerative cervical changes in patients with multiple sclerosis (MS).
METHODS: This cross-sectional study included 130 consecutive adult patients with confirmed MS who underwent cervical spine MRI at a tertiary referral center (2019-2022). Maximum plaque length was measured on T2-weighted sequences. Cervical spondylosis severity was graded using five validated systems: modified Pfirrmann grading (disc degeneration), Modic classification (vertebral endplate changes), Matsumoto grading (posterior disc protrusion), Kang classification (central canal stenosis), and Park grading (foraminal stenosis). Spatial co-localization of plaques and degenerative changes was assessed at each cervical level. Multivariable linear and logistic regression and Spearman correlation were performed were used to evaluate associations.
RESULTS: Degenerative cervical changes were present in 92.3% of patients (mean age 36.2 ± 10.1 years; 72.3% female). Mean plaque length was 8.2 ± 3.4 mm. Plaque length was positively associated with degenerative severity (Spearman r = 0.51, p < 0.001). Each 1-mm increase in plaque length was associated with a 0.52-grade higher Pfirrmann score (β = 0.52, 95% CI 0.38-0.66; p < 0.001) and higher odds of Modic changes (OR = 2.12, 95% CI 1.76-2.55; p < 0.001). At the cervical-level analysis, plaque presence was associated with higher odds of degenerative change at the same level (OR = 3.4, 95% CI 2.5-4.6; p < 0.001).
CONCLUSION: Larger cervical demyelinating plaques were associated with more severe adjacent degenerative changes and greater same-level co-occurrence. Further longitudinal studies are warranted to determine the prognostic significance of cervical plaque characteristics.
METHODS: This cross-sectional study included 130 consecutive adult patients with confirmed MS who underwent cervical spine MRI at a tertiary referral center (2019-2022). Maximum plaque length was measured on T2-weighted sequences. Cervical spondylosis severity was graded using five validated systems: modified Pfirrmann grading (disc degeneration), Modic classification (vertebral endplate changes), Matsumoto grading (posterior disc protrusion), Kang classification (central canal stenosis), and Park grading (foraminal stenosis). Spatial co-localization of plaques and degenerative changes was assessed at each cervical level. Multivariable linear and logistic regression and Spearman correlation were performed were used to evaluate associations.
RESULTS: Degenerative cervical changes were present in 92.3% of patients (mean age 36.2 ± 10.1 years; 72.3% female). Mean plaque length was 8.2 ± 3.4 mm. Plaque length was positively associated with degenerative severity (Spearman r = 0.51, p < 0.001). Each 1-mm increase in plaque length was associated with a 0.52-grade higher Pfirrmann score (β = 0.52, 95% CI 0.38-0.66; p < 0.001) and higher odds of Modic changes (OR = 2.12, 95% CI 1.76-2.55; p < 0.001). At the cervical-level analysis, plaque presence was associated with higher odds of degenerative change at the same level (OR = 3.4, 95% CI 2.5-4.6; p < 0.001).
CONCLUSION: Larger cervical demyelinating plaques were associated with more severe adjacent degenerative changes and greater same-level co-occurrence. Further longitudinal studies are warranted to determine the prognostic significance of cervical plaque characteristics.