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The cervical cord in multiple sclerosis.

D R Oppenheimer

    Neuropathology and Applied Neurobiology
    |March 1, 1978
    PubMed
    Summary
    This summary is machine-generated.

    Mechanical stresses on the spine, particularly during neck flexion, may contribute to lesion formation in multiple sclerosis (MS) patients. This risk is heightened in individuals experiencing Lhermitte's sign.

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    Area of Science:

    • Neurology
    • Pathology
    • Biomechanics

    Background:

    • Multiple sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system.
    • The distribution and morphology of MS lesions provide insights into disease mechanisms.
    • The role of mechanical factors in MS lesion development remains an area of investigation.

    Purpose of the Study:

    • To investigate the topographical distribution and morphology of spinal cord lesions in multiple sclerosis.
    • To explore the potential role of mechanical stresses in the pathogenesis of these lesions, particularly in the cervical region.

    Main Methods:

    • Post-mortem examination of spinal cords from eighteen cases of multiple sclerosis.
    • Detailed analysis of lesion location, focusing on the cervical enlargement.

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  • Morphological assessment of lesions, noting their shape and orientation within white matter tracts.

    • Main Results:

    • Lesions were found to be approximately twice as common in the cervical cord compared to lower spinal levels.
    • A significant prevalence of fan-shaped lesions was observed in the lateral columns of the cervical enlargement.
    • These findings suggest a correlation between mechanical forces and lesion characteristics.

    Conclusions:

    • Mechanical stresses, potentially transmitted via denticulate ligaments during spinal flexion, may influence MS lesion site and shape.
    • Vascular leakage due to tension in denticulate ligaments is proposed as a mechanism for lesion formation.
    • Neck flexion should be considered a potentially dangerous movement for multiple sclerosis patients, especially those exhibiting Lhermitte's sign.