Contributions
Abstract: P1023
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Within the spinal cord, demyelinating lesions are most common in the cervical region and it has been suggested that micro-trauma in this highly mobile region may play a role. Spinal trauma has been shown to disrupt the blood-brain barrier (BBB) and is more common in the context of a narrow spinal canal. Considering that BBB disruption is considered by many to be the first detectable change in Multiple Sclerosis (MS) lesion development, a narrow spinal canal may influence lesion formation.
Objective: Use magnetic resonance imaging (MRI) of the cervical spine to assess the influence of canal dimensions on the presence of demyelinating lesions in MS.
Methods: 94 randomly selected MS patients were included in the study (66 females/24 males; all major subtypes; age = 41±11 years, disease duration = 8±10 years). Routine clinical T2-weighted MR images of the cervical spine were used to measure the maximum anteroposterior (AP) diameters of the cervical spinal canal and spinal cord. The AP space available for the cord was calculated as [spinal canal diameter - spinal cord diameter]. Demyelinating spinal cord lesions were identified on the MR images and binary logistic regression was used to ascertain the effects of the size of the spinal canal on the presence of demyelinating lesions. Age, gender, disease duration, disease type and disc level were all entered as covariates. Additionally, the distance between demyelinating cord lesions and the level at which the spinal canal is smallest was also measured.
Results: A bigger AP spinal canal diameter is associated with reduced risk of a demyelinating lesion at that level (Odds ratio [OR] 0.88, 95% CI 0.77, 0.99; P=0.04), as does having more space for the cord (Odds ratio [OR] 0.86, 95% CI 0.74, 0.99; P=0.04). Additionally, lesions were more common nearer the narrowest part of the cervical canal.
Conclusion: This study has found that a narrower spinal canal is associated with a higher rate of demyelinating spinal cord lesions at that level. It is not known why spinal cord lesions preferentially develop at the cervical cord, but this study suggests that micro-trauma could play a role.
Disclosure: Howra Ktayen: nothing to disclose
Christopher Tench: nothing to disclose
Robert Dineen: nothing to disclose
Paul Morgan: nothing to disclose
Nikos Evangelou: nothing to disclose
Abstract: P1023
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - Imaging
Background: Within the spinal cord, demyelinating lesions are most common in the cervical region and it has been suggested that micro-trauma in this highly mobile region may play a role. Spinal trauma has been shown to disrupt the blood-brain barrier (BBB) and is more common in the context of a narrow spinal canal. Considering that BBB disruption is considered by many to be the first detectable change in Multiple Sclerosis (MS) lesion development, a narrow spinal canal may influence lesion formation.
Objective: Use magnetic resonance imaging (MRI) of the cervical spine to assess the influence of canal dimensions on the presence of demyelinating lesions in MS.
Methods: 94 randomly selected MS patients were included in the study (66 females/24 males; all major subtypes; age = 41±11 years, disease duration = 8±10 years). Routine clinical T2-weighted MR images of the cervical spine were used to measure the maximum anteroposterior (AP) diameters of the cervical spinal canal and spinal cord. The AP space available for the cord was calculated as [spinal canal diameter - spinal cord diameter]. Demyelinating spinal cord lesions were identified on the MR images and binary logistic regression was used to ascertain the effects of the size of the spinal canal on the presence of demyelinating lesions. Age, gender, disease duration, disease type and disc level were all entered as covariates. Additionally, the distance between demyelinating cord lesions and the level at which the spinal canal is smallest was also measured.
Results: A bigger AP spinal canal diameter is associated with reduced risk of a demyelinating lesion at that level (Odds ratio [OR] 0.88, 95% CI 0.77, 0.99; P=0.04), as does having more space for the cord (Odds ratio [OR] 0.86, 95% CI 0.74, 0.99; P=0.04). Additionally, lesions were more common nearer the narrowest part of the cervical canal.
Conclusion: This study has found that a narrower spinal canal is associated with a higher rate of demyelinating spinal cord lesions at that level. It is not known why spinal cord lesions preferentially develop at the cervical cord, but this study suggests that micro-trauma could play a role.
Disclosure: Howra Ktayen: nothing to disclose
Christopher Tench: nothing to disclose
Robert Dineen: nothing to disclose
Paul Morgan: nothing to disclose
Nikos Evangelou: nothing to disclose