Quantitative assessment of asymptomatic spinal cord compression using MRI: a multi-center study

Area of Science:

• Neuroscience
• Radiology
• Gerontology

Background:

• Aging increases neurodegenerative disease risk, with degenerative cervical myelopathy (DCM) being a leading cause of disability.
• Asymptomatic spinal cord compression (ASCC) may precede DCM, but lacks standardized quantitative definition.
• Early detection of ASCC is crucial for preventing age-related neurological decline.

Purpose of the Study:

• To develop and validate a quantitative approach for assessing cervical ASCC using high-resolution MRI.
• To establish a standardized metric for spinal cord compression.
• To analyze the prevalence and progression of ASCC in relation to aging and DCM.

Main Methods:

• Utilized T2-weighted 3T spine MRI scans from healthy controls, ASCC individuals, and DCM patients.
• Employed an automated pipeline (Spinal Cord Toolbox) to calculate maximum spinal cord compression (MSCC) at each slice.
• Analyzed data from three independent datasets conforming to the spine generic protocol.

Main Results:

• ASCC was detected in 17.6% of participants, primarily at C4-C6 levels, with prevalence increasing with age.
• DCM patients were older and showed significantly greater peak MSCC (22.4%) compared to ASCC individuals (13.8%).
• Spinal cord compression appears to initiate in midlife and progress with aging.

Conclusions:

• An automated MRI-based method effectively quantifies spinal cord compression, enabling large-scale analysis in aging populations.
• ASCC is more prevalent in older adults, suggesting a link to age-related neurological impairments.
• The quantitative method can aid in early ASCC detection and monitoring, potentially preventing DCM and mitigating neurological decline.