• Spine · Nov 2021

    Diagnostic Role of Flexion-Extension Central Motor Conduction Time in Cervical Spondylotic Myelopathy.

    • Dougho Park, Byung Hee Kim, Jae Man Cho, Joong Won Yang, Dong Hoon Yang, Man Su Kim, Heum Dai Kwon, and Sang-Eok Lee.
    • Department of Rehabilitation Medicine, Pohang Stroke and Spine Hospital, Pohang, Republic of Korea.
    • Spine. 2021 Nov 15; 46 (22): 156415711564-1571.

    Study DesignRetrospective study.ObjectiveThe purpose of this study was to assess the diagnostic usefulness of flexion-extension central motor conduction time(CMCT) for patients with cervical spondylotic myelopathy (CSM).Summary Of Background DataPrevious reports have suggested that cervical cord compression can be aggravated by neck motions. Thus, the importance of dynamic magnetic resonance imaging (MRI) has been emphasized. However, authors of this study found no reports conducted at the time of this research on whether flexion-extension CMCT was useful for detecting myelopathy.MethodsWe enrolled 227 patients with CSM for this study. We acquired CMCT recorded from the abductor pollicis brevis muscle. All patients underwent a dynamic CMCT study during neck flexion and extension as well as a static study during neutral neck. Static and dynamic MRIs were also scanned. We read all MR images using Muhle classification (MC).ResultsCMCT was significantly delayed with flexion (P < 0.01) and extension (P < 0.01) compared to neutral neck position. Patients with MC grade 1 and 2 showed significant lag in CMCT during flexion and extension. No significant lag by neck motion was observed for those in the MC grade 3. We also evaluated the amount of CMCT variation according to MC grade change (G0, G1, G2) by neck motion. Delta-CMCT of both G1 and G2 were significantly larger than those of G0 in both flexion and extension. In neutral neck, the CMCT showed significant difference between MC grades 1 and 3. They also displayed significant delay with delay with high signal intensity on T2 MRI. More than one-third of the patients whose CMCT was within normal range in neutral neck presented abnormal CMCT in neck flexion (35.3%) and extension (37.8%).ConclusionCMCT is significantly slower in both neck flexion and neck extension than in the neutral neck position. These findings reflect the dynamic cervical cord impingement.Level of Evidence: 4.Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc.

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