title: Association Between Paraspinal Muscle Morphology, Clinical Symptoms, and Functional Status in Patients With Degenerative Cervical Myelopathy.
abstract: METHODS
  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.
  
  
  BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
  
  
  METHODS
  2.
authors.affiliation: McGill University Health Centre, Montreal General Hospital Site, Department of Orthopedic Surgery, Montreal, Quebec, Canada.|PERFORM Centre, Concordia University, Montreal, Quebec, Canada.
authors.forename: Maryse
authors.initials: M
authors.lastname: Fortin
authors.affiliation: McGill University, Faculty of Medicine, Montreal, Quebec, Canada.
authors.forename: Octavian
authors.initials: O
authors.lastname: Dobrescu
authors.affiliation: Simon Fraser University, School of Mechatronic Systems Engineering, Burnaby, British Columbia, Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: Courtemanche
authors.affiliation: Simon Fraser University, School of Mechatronic Systems Engineering, Burnaby, British Columbia, Canada.
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Sparrey
authors.affiliation: McGill University, Faculty of Medicine, Department of Neurology and Neurosurgery, Montreal, Quebec, Canada.
authors.forename: Carlo
authors.initials: C
authors.lastname: Santaguida
authors.affiliation: University of Toronto, Department of Neurosurgery and Spinal Program, Toronto, Ontario, Canada.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Fehlings
authors.affiliation: McGill University Health Centre, Montreal General Hospital Site, Department of Orthopedic Surgery, Montreal, Quebec, Canada.
authors.forename: Michael H
authors.initials: MH
authors.lastname: Weber
mesh_terms: D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000601:surgery; D009334:Neck Muscles / Q000473:pathology / Q000601:surgery; D019547:Neck Pain / Q000209:etiology; D064170:Paraspinal Muscles / Q000473:pathology* / Q000601:surgery; D013118:Spinal Cord Diseases / Q000601:surgery*; D016896:Treatment Outcome