| Purpose:It has been reported that increased adipose tissue are closely related to many diseases and the risk factor of cervical spondylotic myelopathy(CSM)has not fully elucidated,Here we measured the adipose tissue thickness of nape(ATTN)and other anatomic factors about cervical spine,and find they had interesting relationship with CSM.Methods:we collected the data of 289 patients hospitalized(198 men and 91 women)from the spinal surgery department and physical examination center of Qilu Hospital,with an average age of 53.9±10.7 years(range 25?87 years).Among them there were 220 individuals from spinal surgery department and all of them were satisfied the qualification of classic myelopathy(transverse or Brown-Sequard type according to Crandall and Batzdorf's classification).The exclusion criteria of CSM group were:1)exclude the patients with ossification of posterior longitudinal ligament(OPLL);2)Vertebral or spinal canal tumor induced lesions.3)Other causes of spondylosis.Among them there were 154 men and 66 women,and the average age was 53.9± 10.3 years(range 25-81 years),in whom the computed tomographic(CT)and magnetic Resonance Imaging(MRI)were obtained.The control group included 69 people which were selected form physical examination center(44 men and 25 women),the average age of which was 51.9±12.5 years(range 25-87 years).The inclusion criteria of control group were:1)There was no compression or lesion of the spinal cord on MRI;2)There is no underlying disease;All the cases were collected by one researcher and were unaware of the purpose of the experiment.All patients underwent CT and MRI examinations.We measured their neck sagittal diameter(NSD),neck coronary diameter(NCD),cervical length(CL),C6 vertebral sagittal diameter and transverse diameter on CT,as well as the adipose tissue thickness of nape(ATTN)on MRI.The Shapiro-Wilk test was used to determine normal distribution.Kolmogorov Smirnov Z test was performed to determine the distribution of variables for each patient group.Regular variances were assessed with t test and irregulars with Mann-Whitney U test.The Pearson and the Spearman tests were performed to analyze the correlation between variables.A two-sided P value<0.05 indicated a significant difference.Results:The ATTN in the patients with CSM(11.33±14.57 cm)was greater than the control group(9.38±4.02cm)(p<0.005).Japanese Orthopedic Association(JOA)score was evaluated among the groups,and statistical analysis showed that the patents with CSM(12.50±1.98)had lower JOA scores compared with the control group(15.78±2.11).Nevertheless,there was no linear relationship between ATTN and JOA score in CSM group.The ratio of axis area of neck to cervical length(CL)in CSM(122.98± 8.31)was higher than that of the control group(121.91 ±9.30)(p<0.01),which may illustrated that people with short and thick necks are more likely to suffer from CSM.Our study showed that the increased ATTN is associated with the onset of CSM,the size of vertebral body in CSM patients in greater than control group,and ATTN has no relationship with JOA score in people with CSM.So the measurement of ATTN could be a new anthropometric measurement indicator which is helpful for the diagnosis of CSM. |
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