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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Cervical spondylosis is a risk factor for localized spinal cord lesions in multiple sclerosis
Roberto Bomprezzi1, Andrew P Chen2, Christopher C Hemond1
1Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.
Objectives:
To answer the question whether cervical spondylosis would increase the incidence of cord lesions in MS patients, we investigated the statistical association between the two pathologies.
Methods:
We extracted demographics, basic disease characteristics and MRI data of a cohort of 304 consecutive MS patients. For a subset of 176 patients, a detailed analysis independently assessed for each cervical level the co-existence of spinal canal narrowing from spondylosis and corresponding cord signal abnormalities.
Results:
The cohort had typical demographics and in over 80 % of cases there was at least one cord lesion. EDSS correlated with age, disease duration, cerebral lesion burden and spinal cord lesions. After adjusting for either age, disease duration, central lesion burden, or EDSS, the presence of spinal spondylosis was not significantly associated with spinal cord lesions (p > 0.05). In the subset of 176 subjects with the level-by-level spine data, we found a highly statistically significant association (Pearson's χ2 = 23.7, p < 0.001) between canal narrowing and cord lesion at the level directly above or below. This association remained highly significant in both univariable and multivariable logistic regression models adjusting for age, disease duration, MS treatment, cerebral lesion burden and disability scores (p < 0.001).
Conclusions:
The data from our cohort of MS patients suggest an indirect contribution of cervical spondylosis to disability by increasing the risk of developing localized cord lesions. While further studies are needed to confirm the findings and clarify disease mechanisms, closer attention should be paid to worsening spondylosis in patients with MS.
Insights
Cervical spondylosis may increase spinal cord lesions in multiple sclerosis (MS) patients, potentially worsening disability. This association highlights the need for monitoring spondylosis progression in MS care.
Area of Science:
- Neurology
- Radiology
- Spinal Cord Imaging
Background:
- Multiple sclerosis (MS) is a chronic demyelinating disease affecting the central nervous system.
- Cervical spondylosis, a degenerative condition of the cervical spine, is common and may influence MS progression.
- The relationship between cervical spondylosis and spinal cord lesions in MS patients requires further investigation.
Purpose of the Study:
- To investigate the statistical association between cervical spondylosis and the incidence of spinal cord lesions in patients with multiple sclerosis.
- To determine if cervical spondylosis contributes to the development or presence of cord lesions in MS.
Main Methods:
- Retrospective analysis of demographic, clinical, and MRI data from 304 consecutive MS patients.
- Detailed level-by-level assessment of cervical spine canal narrowing (spondylosis) and corresponding spinal cord signal abnormalities in a subset of 176 patients.
- Statistical analysis including logistic regression models adjusted for age, disease duration, lesion burden, and disability scores (EDSS).
Main Results:
- Overall, 80% of the MS cohort exhibited at least one cord lesion.
- Initial analysis showed no significant association between spinal spondylosis and spinal cord lesions after adjusting for confounding factors (p > 0.05).
- However, a highly significant association (p < 0.001) was found between cervical canal narrowing and cord lesions at adjacent levels in the subset analysis, persisting after multivariable adjustments.
Conclusions:
- Cervical spondylosis appears to be indirectly associated with an increased risk of localized spinal cord lesions in MS patients.
- This association suggests a potential contribution of cervical spondylosis to disability progression in MS.
- Further research is warranted to elucidate the underlying mechanisms, emphasizing the clinical importance of monitoring cervical spondylosis in MS management.
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