Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Feb 15;42(4):232-239.
doi: 10.1097/BRS.0000000000001704.

Association Between Paraspinal Muscle Morphology, Clinical Symptoms, and Functional Status in Patients With Degenerative Cervical Myelopathy

Maryse Fortin  1   2 , Octavian Dobrescu  3 , Matthew Courtemanche  4 , Carolyn J Sparrey  4 , Carlo Santaguida  5 , Michael G Fehlings  6 , Michael H Weber  1
Affiliations

Association Between Paraspinal Muscle Morphology, Clinical Symptoms, and Functional Status in Patients With Degenerative Cervical Myelopathy

Maryse Fortin et al. Spine (Phila Pa 1976). .

Abstract

Study design: A cross-sectional study.

Objective: The aim of this study was to assess fatty infiltration and asymmetry of the multifidus (MF), semispinalis cervicis (SCer), semispinalis capitis (SCap), and splenius capitis (SPL) muscles in patients with degenerative cervical myelopathy (DCM), and evaluate their correlations with clinical symptoms and functional scores.

Summary of background data: Cervical muscle alterations have been reported in patients with chronic neck pain, but the assessment of cervical muscle morphology has been overlooked in patients with DCM.

Methods: Thirty-eight patients diagnosed with DCM and spinal cord compression at C4-C5 or C5-C6 (first level of compression) were included. Cervical muscle measurements of cross-sectional area (CSA) and ratio of functional CSA (fat-free area, FCSA) to total CSA were obtained from T2-weighted axial images at the level above, same, and level below the most cranial level of spinal cord compression. Muscle fatty infiltration and asymmetry was assessed at every level and their associations with respect to clinical signs and symptoms and functional scores were investigated.

Results: There was a significant increase in fatty infiltration (decrease in FCSA/CSA ratio) of the MF (P = 0.001) and SPL (P < 0.001) muscles at the level below the spinal cord compression. A significant increase in MF CSA asymmetry was also observed at the level below the compression. Lower MF FCSA/CSA ratio was associated with longer 30-m walking test time. Lower SCer FCSA/CSA was associated with corticospinal distribution motor deficits and atrophy of the hands. Greater asymmetry in SCap CSA was associated with higher Neck Disability Index (NDI) scores, whereas lower asymmetry in MF CSA was associated with a positive Hoffman sign and weakness.

Conclusion: A significant increase in muscle fatty infiltration and CSA asymmetry at the level below the compression was observed in patients with DCM. Our results also suggest an association between cervical muscle morphology and DCM clinical symptoms and functional status.

Level of evidence: 2.

PubMed Disclaimer

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Nouri A, Tetreault L, Singh A, et al. Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis. Spine 2015; 40:E675–E693.
    1. Elliott J, Jull G, Noteboom JT, et al. Fatty infiltration in the cervical extensor muscles in persistent whiplash-associated disorders: a magnetic resonance imaging analysis. Spine 2006; 31:E847–E855.
    1. Chae SH, Lee JL, Kim MS, et al. Cervical multifidus muscle atrophy in patients with unilateral cervical radiculopathy. J Korean Acad Rehab Med 2010; 34:743–751.
    1. Hayashi N, Masumoto T, Abe O, et al. Accuracy of abnormal paraspinal muscle findings on contrast-enhanced MR images as indirect signs of unilateral cervical root-avulsion injury. Radiology 2002; 223:397–402.
    1. Falla D, Jull G, Hodges PW. Feedforward activity of the cervical flexor muscles during voluntary arm movements is delayed in chronic neck pain. Exp. Brain Res 2004; 157:43–48.