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Authors Kong L, Bai J, Zhang B, Shen Y, Tian D
Received 7 November 2017
Accepted for publication 8 February 2018
Published 7 March 2018 Volume 2018:14 Pages 483—488
DOI https://doi.org/10.2147/TCRM.S156364
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Hoa Le
Peer reviewer comments 2
Editor who approved publication: Professor Deyun Wang
Background: The aim of this study was to determine the incidence of coexisting
symptomatic lumbar canal stenosis (LCS) in patients after surgery for cervical
spondylotic myelopathy (CSM) and identify possible predictive factors
associated with it.
Materials and methods: We retrospectively reviewed patients with CSM at
our institution between January 2005 and December 2015. Clinical and
radiographic factors including age, gender, body mass index, Japanese
Orthopedic Association scores, cervical alignment, anteroposterior diameter of
cervical canal, number of levels with CSM, and percentage of cervical cord
compression were investigated. Symptomatic LCS was defined as leg symptoms and
a narrowing of the lumbar spinal canal at one level at least, which is
confirmed by magnetic resonance images of the lumbar spine. Univariate and
multivariate analyses were used to identify possible predictive factors.
Pearson correlation analysis was also conducted to analyze the association
between cervical parameters and percentage of LCS.
Results: A total of 317 patients with CSM met the criteria for
inclusion. There were 39 patients (12.3%) with LCS after cervical surgery
during a mean of 7.3 years’ follow-up. In the multivariate logistic regression
analysis, narrow diameter of cervical canal (OR, 3.96; 95% CI, 1.20–13.04) was
identified as the only independent predictor of symptomatic LCS in CSM
patients. The correlation coefficient between anteroposterior diameter of
cervical canal and severity of LCS indicated a significantly positive linear
relationship with 0.536 (P <0.001).
Conclusion: We found that narrow diameter of cervical canal was
associated with symptomatic LCS in CSM patients. Patients with this risk factor
should be informed the possibility of symptomatic LCS.
Keywords: predictive
factors, lumbar canal stenosis, cervical spondylotic myelopathy, MR imaging