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01-05-2020 | Cervical Myelopathy | Original Article

Patients with degenerative cervical myelopathy have signs of blood spinal cord barrier disruption, and its magnitude correlates with myelopathy severity: a prospective comparative cohort study

Authors: Christian Blume, Matthias Florian Geiger, Lars Ove Brandenburg, Marguerite Müller, Verena Mainz, Johannes Kalder, Walid Albanna, Hans Clusmann, Christian Andreas Mueller

Published in: European Spine Journal | Issue 5/2020

Abstract

Purpose

The aim of this study is to detect the presence of blood spinal cord barrier (BSCB) disruption in patients with degenerative cervical myelopathy (DCM).

Methods

In this prospective non-randomized controlled cohort study, 28 patients with DCM were prospectively included. All patients had indication for neurosurgical decompression. Furthermore, 38 controls with thoracic abdominal aortic aneurysm (TAAA) and indication for surgery were included. All patients underwent neurological examination. Regarding BSCB disruption and intrathecal immunoglobulin (Ig) concentrations, cerebrospinal fluid (CSF) and blood serum were examined for albumin, IgG, IgA and IgM. Quotients (Q) (CSF/serum) were standardized and calculated according to Reibers’ diagnostic criteria.

Results

Patients and controls distinguished significantly in their clinical status. AlbuminQ, as expression of BSCB disruption, was significantly increased in the DCM patients compared to the controls. Quotients of IgG and IgA differed significantly between the groups as an expression of intrathecal diffusion. In the subgroup analysis of patients with mild/moderate clinical status of myelopathy and patients with severe clinical status, the disruption of the BSCB was significantly increased with clinical severity. Likewise, IgAQ and IgGQ presented increased quotients related to the clinical severity of myelopathy.

Conclusion

In this study, we detected an increased permeability and disruption of the BSCB in DCM patients. The severity of BSCB disruption and the diffusion of Ig are related to the clinical status in our patient cohort. Having documented this particular pathomechanism in patients with DCM, we suggest that this diagnostic tool cloud be an important addition to surgical decision making in the future.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

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Title: Patients with degenerative cervical myelopathy have signs of blood spinal cord barrier disruption, and its magnitude correlates with myelopathy severity: a prospective comparative cohort study
Authors: Christian Blume
Matthias Florian Geiger
Lars Ove Brandenburg
Marguerite Müller
Verena Mainz
Johannes Kalder
Walid Albanna
Hans Clusmann
Christian Andreas Mueller
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Cervical Myelopathy
Abdominal Aortic Aneurysm
Abdominal Aortic Aneurysm
Published in: European Spine Journal / Issue 5/2020
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-020-06298-7

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Patients with degenerative cervical myelopathy have signs of blood spinal cord barrier disruption, and its magnitude correlates with myelopathy severity: a prospective comparative cohort study

Abstract

Purpose

Methods

Results

Conclusion

Graphic abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Graphic abstract

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