Abstract：
OBJECTIVE: No standardized magnetic resonance imaging (MRI) parameters have defined the 3-dimensional morphoanatomy and relevant spinal cord occupation ratios (occupation of spinal cord dimensions/similar dimensions within the spinal canal) in congenital cervical stenosis (CCS).
METHODS: A retrospective, comparative analysis was conducted on 200 patients >18 years of age with myelopathy and CCS (mean age, 52.4 years) and 200 age-matched controls with no myelopathy or radiculopathy. The variables assessed from high resolution MRI included sagittal and axial spinal canal dimensions (MRI Torg-Pavlov ratios) from C3 to C7. Morphometric dimensions from the sagittal retrodiscal and retrovertebral regions as well as axial MRI dimensions were compared. Sagittal and axial spinal cord occupation ratios were defined and correlated with spinal canal dimensions.
RESULTS: Multivariate analyses indicated reduced sagittal and axial anteroposterior (AP) spinal canal dimensions and a large reduction in transverse spinal canal dimensions at all spinal levels. There was a small significant correlation between AP sagittal spinal canal dimensions and axial transverse spinal canal dimensions at C3-C5, but not at C5-C6. Small correlations were noted between AP sagittal spinal canal dimensions and AP axial spinal cord and axial cross-sectional area occupation ratios at C3-C6, but there was no correlation with axial mediolateral spinal cord occupation ratios.
CONCLUSIONS: The stenosis effect can involve any dimension, including the transverse spinal canal dimension, independent of other dimensions. Owing to the varied observed morphoanatomies, a classification algorithm that defines CCS specific phenotypes was formulated. Objectivizing the stenosis morphoanatomy may allow for data-driven patient-focused decompression approaches in the future.
METHODS: A retrospective, comparative analysis was conducted on 200 patients >18 years of age with myelopathy and CCS (mean age, 52.4 years) and 200 age-matched controls with no myelopathy or radiculopathy. The variables assessed from high resolution MRI included sagittal and axial spinal canal dimensions (MRI Torg-Pavlov ratios) from C3 to C7. Morphometric dimensions from the sagittal retrodiscal and retrovertebral regions as well as axial MRI dimensions were compared. Sagittal and axial spinal cord occupation ratios were defined and correlated with spinal canal dimensions.
RESULTS: Multivariate analyses indicated reduced sagittal and axial anteroposterior (AP) spinal canal dimensions and a large reduction in transverse spinal canal dimensions at all spinal levels. There was a small significant correlation between AP sagittal spinal canal dimensions and axial transverse spinal canal dimensions at C3-C5, but not at C5-C6. Small correlations were noted between AP sagittal spinal canal dimensions and AP axial spinal cord and axial cross-sectional area occupation ratios at C3-C6, but there was no correlation with axial mediolateral spinal cord occupation ratios.
CONCLUSIONS: The stenosis effect can involve any dimension, including the transverse spinal canal dimension, independent of other dimensions. Owing to the varied observed morphoanatomies, a classification algorithm that defines CCS specific phenotypes was formulated. Objectivizing the stenosis morphoanatomy may allow for data-driven patient-focused decompression approaches in the future.
摘要：
目的：没有标准化的MRI参数定义了先天性宫颈狭窄CCS的三维形态解剖学和相关的脊髓占用比（脊髓尺寸/椎管内相似尺寸的占用）。
方法：回顾性研究，对200例年龄>18岁的脊髓病患者进行了比较分析(平均年龄，52.4岁）和CCS和200个年龄匹配的对照，没有脊髓病或神经根病。从高分辨率MRI评估的变量包括C3-C7的矢状和轴向椎管尺寸（MRITorg比率）。比较了矢状位椎间盘后和椎体后区域的形态测量尺寸以及轴向MRI尺寸。定义矢状和轴向脊髓占据比，并与椎管尺寸相关。
结果：多变量分析显示矢状和轴向前后AP椎管尺寸减小，所有脊柱水平的横向椎管尺寸均大幅减小。AP矢状椎管尺寸与C3-C5的轴向横向椎管尺寸之间存在很小的显着相关性，而C5-C6则没有。在C3-C6时，AP矢状椎管尺寸与AP轴向脊髓和轴向横截面面积占用比之间的相关性很小，但与轴向中外侧脊髓占用比没有相关性。
结论：狭窄效应可以涉及任何维度，包括横向椎管尺寸，独立于其他维度。由于观察到的形态解剖变化，制定了定义CCS特异性表型的分类算法.对狭窄的形态解剖学进行客观化可以在将来允许数据驱动的以患者为中心的减压方法。
方法：回顾性研究，对200例年龄>18岁的脊髓病患者进行了比较分析(平均年龄，52.4岁）和CCS和200个年龄匹配的对照，没有脊髓病或神经根病。从高分辨率MRI评估的变量包括C3-C7的矢状和轴向椎管尺寸（MRITorg比率）。比较了矢状位椎间盘后和椎体后区域的形态测量尺寸以及轴向MRI尺寸。定义矢状和轴向脊髓占据比，并与椎管尺寸相关。
结果：多变量分析显示矢状和轴向前后AP椎管尺寸减小，所有脊柱水平的横向椎管尺寸均大幅减小。AP矢状椎管尺寸与C3-C5的轴向横向椎管尺寸之间存在很小的显着相关性，而C5-C6则没有。在C3-C6时，AP矢状椎管尺寸与AP轴向脊髓和轴向横截面面积占用比之间的相关性很小，但与轴向中外侧脊髓占用比没有相关性。
结论：狭窄效应可以涉及任何维度，包括横向椎管尺寸，独立于其他维度。由于观察到的形态解剖变化，制定了定义CCS特异性表型的分类算法.对狭窄的形态解剖学进行客观化可以在将来允许数据驱动的以患者为中心的减压方法。
