Aims Developmental cervical spinal stenosis (DcSS) is a well-known predisposing factor for degenerative cervical myelopathy (DCM) but there is a lack of consensus on its definition. This study aims to define DcSS based on MRI, and its multilevel characteristics, to assess the prevalence of DcSS in the general population, and to evaluate the presence of DcSS in the prediction of developing DCM. Methods This cross-sectional study analyzed MRI spine morphological parameters at C3 to C7 (including anteroposterior (AP) diameter of spinal canal, spinal cord, and vertebral body) from DCM patients (n = 95) and individuals recruited from the general population (n = 2,019). Level-specific median AP spinal canal diameter from DCM patients was used to screen for stenotic levels in the population-based cohort. An individual with multilevel (≥ 3 vertebral levels) AP canal diameter smaller than the DCM median values was considered as having DcSS. The most optimal cut-off canal diameter per level for DcSS was determined by receiver operating characteristic analyses, and multivariable logistic regression was performed for the prediction of developing DCM that required surgery. Results A total of 2,114 individuals aged 64.6 years (SD 11.9) who underwent surgery from March 2009 to December 2016 were studied. The most optimal cut-off canal diameters for DcSS are: C3 < 12.9 mm, C4 < 11.8 mm, C5 < 11.9 mm, C6 < 12.3 mm, and C7 < 13.3 mm. Overall, 13.0% (262 of 2,019) of the population-based cohort had multilevel DcSS. Multilevel DcSS (odds ratio (OR) 6.12 (95% CI 3.97 to 9.42); p < 0.001) and male sex (OR 4.06 (95% CI 2.55 to 6.45); p < 0.001) were predictors of developing DCM. Conclusion This is the first MRI-based study for defining DcSS with multilevel canal narrowing. Level-specific cut-off canal diameters for DcSS can be used for early identification of individuals at risk of developing DCM. Individuals with DcSS at ≥ three levels and male sex are recommended for close monitoring or early intervention to avoid traumatic spinal cord injuries from stenosis.

中文翻译：

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使用 MRI 定义多节段发育性颈椎管狭窄症。


目的 发育性颈椎管狭窄症 （DcSS） 是退行性脊髓型颈椎病 （DCM） 的已知诱发因素，但对其定义缺乏共识。本研究旨在基于 MRI 定义 DcSS 及其多层次特征，评估 DcSS 在普通人群中的患病率，并评估 DcSS 在预测 DCM 发展中的存在。方法 这项横断面研究分析了 DCM 患者 （n = 95） 和从普通人群中招募的个体 （n = 2,019） 在 C3 至 C7 处的 MRI 脊柱形态参数 （包括椎管、脊髓和椎体的前后 （AP） 直径）。DCM 患者的水平特异性中位 AP 椎管直径用于筛查基于人群的队列中的狭窄水平。多节级 （≥ 3 个椎体水平） AP 管直径小于 DCM 中位数的个体被认为患有 DcSS。通过受试者工作特征分析确定 DcSS 每节段的最佳截断管直径，并进行多变量 logistic 回归以预测需要手术的 DCM。结果 共研究了 2009 年 3 月至 2016年12月接受手术的 2,114 例年龄 64.6 岁 （SD 11.9） 的个体。DcSS 的最佳截留管直径为：C3 < 12.9 mm、C4 < 11.8 mm、C5 < 11.9 mm、C6 < 12.3 mm 和 C7 < 13.3 mm。总体而言，基于人群的队列中有 13.0%（2,019 人中的 262 人）患有多水平 DcSS。多水平 DcSS （比值比 （OR） 6.12 （95% CI 3.97 至 9.42）;p < 0.001）和男性 （OR 4.06 （95% CI 2.55 至 6.45）;p < 0.001） 是发生 DCM 的预测因子。结论 这是第一项基于 MRI 的研究，用于定义具有多节级管狭窄的 DcSS。 DcSS 的水平特异性截留管直径可用于早期识别有发生 DCM 风险的个体。建议 DcSS ≥ 3 级个体和男性进行密切监测或早期干预，以避免狭窄引起的创伤性脊髓损伤。