Fatty infiltration in cervical flexors and extensors in patients with degenerative cervical myelopathy using a multi-muscle segmentation model

PLOS ONE, 2021 · DOI: https://doi.org/10.1371/journal.pone.0253863 · Published: June 25, 2021

Simple Explanation

This study looks at the relationship between fat buildup in neck muscles and the severity of degenerative cervical myelopathy (DCM), a condition affecting the spinal cord in the neck. The researchers used a special type of MRI to measure fat infiltration in specific neck muscles and compared these measurements with clinical assessments of disability. The goal was to see if more fat in these muscles was linked to greater disability and poorer outcomes after surgery for DCM.

Study Duration

Not specified

Participants

18 patients with DCM and 25 controls

Evidence Level

Cross-sectional case control study

Key Findings

1
Patients with DCM had significantly higher muscle fat infiltration (MFI) in the multifidus and semispinalis cervicis (MFSS) and longus capitis/colli (LC) muscles compared to healthy controls.
2
Increased MFI in LC and MFSS was associated with higher levels of clinical disability, as indicated by Nurick and mJOA scores.
3
Higher MFI in LC muscles before surgery was associated with better post-surgical improvement in Nurick and mJOA scores.

Research Summary

This study investigated the relationship between muscle fat infiltration (MFI) in cervical muscles and clinical disability in patients with degenerative cervical myelopathy (DCM). The findings revealed that patients with DCM had significantly higher MFI in specific neck muscles compared to healthy controls, and increased MFI was associated with greater clinical disability. Interestingly, higher pre-surgical MFI in certain muscles was linked to better post-surgical outcomes, suggesting MFI as a potential biomarker for assessing and managing DCM.

Practical Implications

Diagnostic Potential

MFI could serve as a potential biomarker for assessing the severity and progression of DCM.

Therapeutic Target

Targeted physical therapy interventions focusing on specific neck muscles may improve clinical outcomes in DCM patients.

Prognostic Indicator

Pre-surgical MFI levels could potentially predict post-surgical recovery, aiding in patient selection and management strategies.

Study Limitations

1
The study acknowledges that factors like total lean body mass, physical activity, or neck-specific exercise levels could influence cervical musculature composition.
2
Quantification of MFI depends on the accuracy of muscle segmentation by the CNN, and differences in MRI acquisition may affect muscle boundary definition.
3
The study did not control for differences in spinal alignment between participant groups, which could also affect neck disability in patients with DCM.

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