Intramedullary Stress and Strain Correlate with Neurological Dysfunction in Degenerative Cervical Myelopathy. Appl Sci (Basel) 2025 Jan;15(2)
Date
02/24/2025Pubmed ID
39991023Pubmed Central ID
PMC11845244DOI
10.3390/app15020886Scopus ID
2-s2.0-85215797547 (requires institutional sign-in at Scopus site) 2 CitationsAbstract
Degenerative cervical myelopathy (DCM) is characterized by progressive neurological dysfunction, yet the contribution of intramedullary stress and strain during neck motion remains unclear. This study used patient-specific finite element models (FEMs) of the cervical spine and spinal cord to examine the relationship between spinal cord biomechanics and neurological dysfunction. Twenty DCM patients (mean age 62.7 ± 11.6 years; thirteen females) underwent pre-surgical MRI-based modeling to quantify von Mises stress and maximum principal strains at the level of maximum spinal cord compression during simulated neck flexion and extension. Pre-surgical functional assessments included hand sensation, dexterity, and balance. During flexion, the mean intramedullary stress and strain at the level of maximum compression were 7.6 ± 3.7 kPa and 4.3 ± 2.0%, respectively. Increased intramedullary strain during flexion correlated with decreased right-hand sensation (r = -0.58, p = 0.014), impaired right-hand dexterity (r = -0.50, p = 0.048), and prolonged dexterity time (r = 0.52, p = 0.039). Similar correlations were observed with intramedullary stress. Patients with severe DCM exhibited significantly greater stress during flexion than those with mild/moderate disease (p = 0.03). These findings underscore the impact of dynamic spinal cord biomechanics on neurological dysfunction and support their potential utility in improving DCM diagnosis and management.
