Introduction
Materials and methods
Study participants
Study methods
Magnetic resonance imaging (MRI) scanning
Criteria for the assessment of degenerative changes in the cervical spine
Protrusion of the intervertebral disc |
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Grade 0: No herniated disc |
Grade 1: Herniated disc beyond the posterior border of the vertebral body without spinal cord compression |
Grade 2: Herniated disc beyond the posterior border of the vertebral body with spinal cord compression |
Spinal canal stenosis |
Grade 0: Normal or mild subarachnoid stenosis |
Grade 1: Anterior subarachnoid stenosis ≥ 50% without spinal cord compression |
Grade 2: Spinal stenosis ≥ 50% with spinal cord compression |
Stenosis of the intervertebral space |
Grade 0: > 75% upper healthy disc height |
Grade 1: 50%–75% upper healthy disc height |
Grade 2: < 50% upper healthy disc height |
Dorsal osteophytosis formation |
Grade 0: None |
Grade 1: Evident dorsal osteophytosis |
MRI assessment criteria for myodural bridge complex (MDBC) staging
Statistical analyses
Results
The MDBC imaging classification
Type | Type A MDBC | Type B MDBC | Type C MDBC | Type D MDBC |
---|---|---|---|---|
Number of patients (patients [%]) | 499 (46.0) | 213 (19.6) | 208 (19.2) | 165 (15.2) |
Consistency analysis of MDBC classification
Univariate analysis of factors influencing MDBC imaging classification
Influencing factors | Type A MDBC (patients [%]) | Type B MDBC (patients [%]) | Type C MDBC (patients [%]) | Type D MDBC (patients [%]) | χ2 | P |
---|---|---|---|---|---|---|
Sex | ||||||
Male | 220 (44.1) | 103 (48.4) | 98 (47.1) | 97 (58.8) | 10.804 | 0.013* |
Female | 279 (55.9) | 110 (51.6) | 110 (52.9) | 68 (41.2) | ||
Age (group) | ||||||
20–29 | 73 (36.5) | 39 (19.5) | 49 (24.5) | 39 (19.5) | 29.551 | 0.003* |
30–39 | 119 (42.8) | 60 (21.6) | 47 (16.9) | 52 (18.7) | ||
40–49 | 102 (46.2) | 48 (21.7) | 42 (19.0) | 29 (13.1) | ||
50–59 | 105 (50.0) | 35 (16.7) | 37 (17.6) | 33 (15.7) | ||
60–69 | 100 (56.8) | 31 (17.6) | 33 (18.8) | 12 (6.8) |
Indicators | Type A MDBC (patients [%]) | Type B MDBC (patients [%]) | Type C MDBC (patients [%]) | Type D MDBC (patients [%]) | χ2 | P |
---|---|---|---|---|---|---|
Degree of intervertebral disc protrusion | ||||||
Grade 0 | 105 (48.4) | 38 (17.5) | 39 (18.0) | 35 (16.1) | 2.713 | 0.844 |
Grade 1 | 294 (44.5) | 136 (20.6) | 133 (20.1) | 98 (14.8) | ||
Grade 2 | 100 (48.3) | 39 (18.8) | 36 (17.4) | 32 (15.5) | ||
Degree of spinal canal stenosis | ||||||
Grade 0 | 243 (44.0) | 115 (20.8) | 108 (19.6) | 86 (15.6) | 2.599 | 0.857 |
Grade 1 | 157 (47.9) | 61 (18.6) | 64 (19.5) | 46 (14.0) | ||
Grade 2 | 99 (48.3) | 37 (18.0) | 36 (17.6) | 33 (16.1) | ||
Degree of intervertebral disc narrowing | ||||||
Grade 0 | 231 (40.3) | 118 (20.6) | 111 (19.4) | 113 (19.7) | 30.702 | 0* |
Grade 1 | 116 (55.0) | 51 (16.9) | 50 (16.6) | 35 (11.6) | ||
Grade 2 | 102 (48.6) | 44 (21.0) | 47 (22.4) | 17 (8.1) | ||
Dorsal osteophytosis formation | ||||||
Grade 0 | 185 (37.5) | 89 (18.1) | 113 (22.9) | 106 (21.5) | 45.390 | 0* |
Grade 1 | 314 (53.0) | 124 (20.9) | 95 (16.0) | 59 (10.0) |
Indicators | Type A MDBC (patients [%]) | Type B MDBC (patients [%]) | Type C MDBC (patients [%]) | Type D MDBC (patients [%]) | χ2 | P |
---|---|---|---|---|---|---|
Joint action of multiple degenerative changes | ||||||
Normal cervical vertebra | 105 (48.4) | 38 (17.5) | 39 (18.0) | 35 (16.1) | 110.079 | 0* |
Protrusion of the intervertebral disc only | 47 (27.3) | 41 (23.8) | 46 (26.7) | 38 (22.1) | ||
Protrusion of the intervertebral disc + spinal canal stenosis | 17 (27.0) | 6 (9.5) | 13 (20.6) | 27 (42.9) | ||
Protrusion of the intervertebral disc + intervertebral space stenosis | 8 (42.1) | 2 (10.5) | 5 (26.3) | 4 (21.1) | ||
Protrusion of the intervertebral disc + dorsal osteophytosis | 25 (48.1) | 15 (28.8) | 7 (13.5) | 5 (9.6) | ||
Protrusion of the intervertebral disc + spinal canal stenosis + intervertebral space stenosis | 8 (34.8) | 3 (13.0) | 10 (43.5) | 2 (8.7) | ||
Protrusion of the intervertebral disc + spinal canal stenosis + dorsal osteophytosis | 37 (53.6) | 18 (26.1) | 6 (8.7) | 8 (11.6) | ||
Protrusion of the intervertebral disc + intervertebral space stenosis + dorsal osteophytosis | 58 (63.0) | 19 (20.7) | 11 (12.0) | 4 (4.3) | ||
Protrusion of the intervertebral disc + spinal canal stenosis + intervertebral space stenosis + dorsal osteophytosis | 194 (51.3) | 71 (18.8) | 71 (18.8) | 42 (11.1) |
Multi-factor analysis of factors influencing MDBC imaging classification
Typing | Factors | B | P | OR | OR 95% CI | |
---|---|---|---|---|---|---|
Type B MDBC | Age (group) | – 0.023 | 0.011* | 0.977 | 0.959 | 0.995 |
Degree of intervertebral space stenosis | 0.040 | 0.793 | 1.041 | 0.769 | 1.409 | |
Formation of dorsal osteophytosis | 0.501 | 0.196 | 1.651 | 0.772 | 3.530 | |
Joint action of multiple degenerative changes | ||||||
Protrusion of the intervertebral disc only | 1.015 | 0* | 2.760 | 1.561 | 4.880 | |
Cervical degenerative changes with no spinal canal stenosis | 0.073 | 0.869 | 1.076 | 0.450 | 2.572 | |
Cervical degenerative changes with spinal canal stenosis | 0.076 | 0.856 | 1.078 | 0.477 | 2.437 | |
Normal cervical vertebra | 0 | |||||
Type C MDBC | Age (group) | – 0.012 | 0.212 | 0.988 | 0.969 | 1.007 |
Degree of intervertebral space stenosis | 0.462 | 0.006* | 1.586 | 1.141 | 2.206 | |
Dorsal osteophytosis formation | – 1.216 | 0* | 0.296 | 0.158 | 0.555 | |
Joint action of multiple degenerative changes | ||||||
Protrusion of the intervertebral disc only | 1.037 | 0* | 2.821 | 1.611 | 4.939 | |
Cervical degenerative changes with no spinal canal stenosis | 0.464 | 0.237 | 1.590 | 0.737 | 3.431 | |
Cervical degenerative changes with spinal canal stenosis | 0.792 | 0.022* | 2.207 | 1.123 | 4.339 | |
Normal cervical vertebra | 0 | |||||
Type D MDBC | Age (group) | – 0.011 | 0.295 | 0.989 | 0.969 | 1.010 |
Degree of intervertebral space stenosis | – 0.280 | 0.136 | 0.756 | 0.523 | 1.092 | |
Dorsal osteophytosis formation | – 1.276 | 0* | 0.279 | 0.148 | 0.527 | |
Joint action of multiple degenerative changes | ||||||
Protrusion of the intervertebral disc only | 0.949 | 0.002* | 2.582 | 1.435 | 4.645 | |
Cervical degenerative changes with no spinal canal stenosis | 0.669 | 0.126 | 1.953 | 0.829 | 4.603 | |
Cervical degenerative changes with spinal canal stenosis | 1.414 | 0* | 4.112 | 2.118 | 7.983 | |
Normal cervical vertebra | 0 |