Article Figures & Data
Figures
- FIG 1.
CSF space in controls and patients The CSF cross-sectional area (CSA) was smaller in patients with segments classified as stenotic (dark gray plots) compared with segments classified as nonstenotic (light gray plots). At C7 in 32 patients, the CSA was available, but no segment was classified as stenotic. The asterisk indicates P < .001.
- FIG 2.
Spinal cord motion pattern in healthy controls and patients (stenotic segments). Spinal cord velocity values are displayed within 20 time points during the cardiac cycle in healthy controls (left column) and stenotic segments in patients (monosegmental and multisegmental stenoses, right column). Velocity values are pooled per cervical segment. Single measures are displayed in light gray; the black line represents the group mean.
- FIG 3.
Displacement values in controls and patients. Displacement values (entire cardiac cycle) are increased manifold in patients (monosegmental and multisegmental stenoses) in segments classified as stenotic (dark gray plots) and nonstenotic (light gray plots) compared with controls (white plots). In groups with only 1 measurement, no analysis was possible. Double asterisks indicate P < .001; asterisk, P = .015.
- FIG 4.
Timing of the positive motion peaks in controls and patients. The positive motion peak was delayed in patients (monosegmental and multisegmental stenoses) in segments classified as stenotic (dark gray plots) at C3, C4, C5, and C6 and in segments classified as nonstenotic (light gray plots) at C4 compared with controls (white plots). In groups with only 1 measurement, no analysis was possible. Double asterisks indicate P < .01; asterisk, P ≤ .021.
- FIG 5.
Spinal cord motion at C2 regarding the distance to the next stenosis and the number of stenotic segments. In patients (monosegmental and multisegmental stenoses), displacement (entire cardiac cycle) differs with the distance to the next stenosis (A) and the number of stenotic segments (B).
- FIG 6.
Comparison of physiologic and pathologic spinal cord motion. At C5 in a nonstenotic segment in a healthy control (A, axial T2-weighted), only moderate velocities can be observed in phase-contrast imaging with light gray shading of the cord (B, axial PCMR, red dotted circle). In contrast, in a patient’s stenotic segment (C, axial T2-weighted), extensively increased spinal cord motion velocity can be identified by black shading of the spinal cord (D; axial PCMR; red dotted circle). While the phase-contrast images (B, healthy control; D, patient) show the maximum caudal velocity, the velocity graphs (E, healthy control; F, patient) display the velocity at 20 time points during 1 cardiac cycle. While in physiologic conditions, only a moderate biphasic oscillation in the second half of the cardiac cycle (E, time points 11–20) and no motion during the first half (E, time points 1–10) can be observed; in cervical stenosis, the spinal cord shows an extensively increased oscillation in the second half (F, time points 11–20; red arrows) and ongoing upward motion in the first half (F, time points 1–10; red dotted arrow).
Tables
- Table 1:
Number of stenotic segments and number of sufficient phase-contrast measurements in patients
Segment No. Sufficient Measurements No. Stenotic Segments Monosegmental Stenosis, Stenotic Segment Multisegmental Stenosis, Stenotic Segment Monosegmental Stenosis, Nonstenotic Segment Multisegmental Stenosis, Nonstenotic Segment C2 1 0 1 18 34 C3 22 1 14 0 1 C4 23 4 14 4 3 C5 41 10 19 4 2 C6 22 0 5 4 1 C7 1 0 1 0 1 Total 110 15 54 30 42 Controls (n = 18) Patients (n = 55) P Sex (male) 9 (50%) 37 (67.3%) .368 Age (yr) 62.2 [SD, 6.5] 56.2 [SD, 12.0] .024 Body size (m) 1.70 [SD, 0.06] 1.70 [SD, 0.08] .947 Body weight (kg) 67.2 [SD, 12.3] 77.9 [SD, 13.6] .007 Monosegmental stenosis 19 (34.5%) Multisegmental stenosis 36 (65.5%)
