The Relationship Between Preoperative Clinical Presentation and Quantitative Magnetic Resonance Imaging Features in Patients With Degenerative Cervical Myelopathy

BACKGROUND: Degenerative cervical myelopathy encompasses a group of conditions resulting in progressive spinal cord injury through static and dynamic compression. Although a constellation of changes can present on magnetic resonance imaging (MRI), the clinical significance of these findings remains a subject of controversy and discussion. OBJECTIVE: To investigate the relationship between clinical presentation and quantitative MRI features in patients with degenerative cervical myelopathy. METHODS: A secondary analysis of MRI and clinical data from 114 patients enrolled in a prospective, multicenter study was conducted. MRIs were assessed for maximum spinal cord compression (MSCC), maximum canal compromise (MCC), signal changes, and a signal change ratio (SCR). MRI features were compared between patients with and those without myelopathy symptoms with the use of t tests. Correlations between MRI features and duration of symptoms were assessed with the Spearman. RESULTS: Numb hands and Hoffmann sign were associated with greater MSCC (P <.05); broad-based, unstable gait, impairment of gait, and Hoffmann sign were associated with greaterMCC (P<. 05); andnumbhands, Hoffmann sign, Babinski sign, lower limb spasticity, hyperreflexia, and T1 hypointensitywere associated with greater SCR (P<. 05). Patientswith a T2 signal hyperintensity had greater MSCC and MCC (P <.001). CONCLUSION: MSCC was associated with upper limb manifestations, and SCR was associated with upper limb, lower limb, and general neurological deficits. Hoffmann sign occurred more commonly in patients with a greater MSCC, MCC and SCR. The Lhermitte phenomenon presentedmore commonly in patientswith a lower SCR andmay be an early indicator of mild spinal cord involvement. Research to validate these findings is required.