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Cervical spinal degenerative disease in multiple sclerosis

Cervical spinal degenerative disease in multiple sclerosis
Cervical spinal degenerative disease in multiple sclerosis
Background and purpose: root and cord irritation from cervical spinal degenerative disease (SDD) may share clinical features with progressive multiple sclerosis (MS), so diagnostic overshadowing may occur. We hypothesized that cervical stenotic SDD is commoner in people with progressive MS, compared to controls.

Methods: a retrospective case-control study of 111 cases (56 with progressive MS and 55 age- and sex-matched controls) was conducted. Five types of cervical SDD (disc degeneration, posterior disc protrusion, endplate changes, canal stenosis and foraminal stenosis) were assessed objectively on magnetic resonance imaging using published scales. Multivariable regression analysis was performed.

Results: moderate-to-severe cervical spinal degeneration occurred more frequently in progressive MS, compared to controls. In multivariable regression, foraminal stenosis was three times more likely in progressive MS (odds ratio 3.20, 95% confidence interval 1.27, 8.09; p = 0.014), and was more severe (p = 0.009). This finding was confirmed on retrospective evaluation of clinical radiology reports in the same population. Foraminal stenosis was twice as likely in progressive MS, compared to relapsing-remitting MS.

Conclusions: people with progressive MS are susceptible to foraminal stenosis. A higher index of suspicion for cervical SDD is required when appropriate neurological symptoms occur in the setting of progressive MS, to guide appropriate treatment or monitoring.
disc disease, foraminal stenosis, multiple sclerosis, radiculopathy, spinal degenerative disease
1351-5101
2497-2502
Chhugani, Simran
c97445a2-cd47-4364-9e8b-239626c05e85
Agarwal, Nivedita
ec451638-a8e6-477f-864d-25c653fa70a0
Sheikh, Faraz
e702d36e-186a-4821-b6bf-b6e7b69db676
Borca, Florina
31fc3965-6bcf-4fd6-85bc-8b0f99f62473
Spanoulis, Aginor
4b725a93-fffa-4e05-9046-c134990e6b94
Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b
Chhugani, Simran
c97445a2-cd47-4364-9e8b-239626c05e85
Agarwal, Nivedita
ec451638-a8e6-477f-864d-25c653fa70a0
Sheikh, Faraz
e702d36e-186a-4821-b6bf-b6e7b69db676
Borca, Florina
31fc3965-6bcf-4fd6-85bc-8b0f99f62473
Spanoulis, Aginor
4b725a93-fffa-4e05-9046-c134990e6b94
Galea, Ian
66209a2f-f7e6-4d63-afe4-e9299f156f0b

Chhugani, Simran, Agarwal, Nivedita, Sheikh, Faraz, Borca, Florina, Spanoulis, Aginor and Galea, Ian (2021) Cervical spinal degenerative disease in multiple sclerosis. European Journal of Neurology, 28 (8), 2497-2502. (doi:10.1111/ene.14855).

Record type: Article

Abstract

Background and purpose: root and cord irritation from cervical spinal degenerative disease (SDD) may share clinical features with progressive multiple sclerosis (MS), so diagnostic overshadowing may occur. We hypothesized that cervical stenotic SDD is commoner in people with progressive MS, compared to controls.

Methods: a retrospective case-control study of 111 cases (56 with progressive MS and 55 age- and sex-matched controls) was conducted. Five types of cervical SDD (disc degeneration, posterior disc protrusion, endplate changes, canal stenosis and foraminal stenosis) were assessed objectively on magnetic resonance imaging using published scales. Multivariable regression analysis was performed.

Results: moderate-to-severe cervical spinal degeneration occurred more frequently in progressive MS, compared to controls. In multivariable regression, foraminal stenosis was three times more likely in progressive MS (odds ratio 3.20, 95% confidence interval 1.27, 8.09; p = 0.014), and was more severe (p = 0.009). This finding was confirmed on retrospective evaluation of clinical radiology reports in the same population. Foraminal stenosis was twice as likely in progressive MS, compared to relapsing-remitting MS.

Conclusions: people with progressive MS are susceptible to foraminal stenosis. A higher index of suspicion for cervical SDD is required when appropriate neurological symptoms occur in the setting of progressive MS, to guide appropriate treatment or monitoring.

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ene.14855 - Version of Record
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More information

Accepted/In Press date: 24 March 2021
e-pub ahead of print date: 5 April 2021
Additional Information: Funding Information: This study was supported by funding from the National Institute for Health Research, UK. Publisher Copyright: © 2021 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
Keywords: disc disease, foraminal stenosis, multiple sclerosis, radiculopathy, spinal degenerative disease

Identifiers

Local EPrints ID: 449274
URI: http://eprints.soton.ac.uk/id/eprint/449274
ISSN: 1351-5101
PURE UUID: 381d0392-04cc-4e13-97a5-300c208bddda
ORCID for Ian Galea: ORCID iD orcid.org/0000-0002-1268-5102

Catalogue record

Date deposited: 21 May 2021 16:31
Last modified: 24 Nov 2021 02:38

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Contributors

Author: Simran Chhugani
Author: Nivedita Agarwal
Author: Faraz Sheikh
Author: Florina Borca
Author: Aginor Spanoulis
Author: Ian Galea ORCID iD

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