Scholarlink

Purpose <p>Degenerative cervical myelopathy (DCM) and idiopathic normal pressure hydrocephalus (iNPH) share symptoms such as gait disturbance and urinary dysfunction, especially in the elderly. While the incidence of DCM in patients with iNPH is reported, the prevalence of iNPH in patients with DCM remains unclear. This study investigates the prevalence of iNPH in DCM patients.</p> Methods <p>This retrospective cohort study included 83 patients undergoing decompression surgery for DCM between April 2018 and March 2023. Brain MRI performed within three years prior to surgery was analyzed. Patients were categorized into two groups based on the Evans Index (EI): those with EI &gt; 0.3 were classified as the Suspected-iNPH group, and those with EI ≤ 0.3 as the Non-iNPH group. Pre- and postoperative Japanese Orthopedic Association (JOA) scores and Patient-Reported Outcomes (PROs), including the Neck Disability Index (NDI), EuroQOL-5D (EQ-5D), Core Outcome Measure Index (COMI), and Numerical Rating Scale (NRS) for pain, were compared. Suspected-iNPH cases underwent further analysis to identify disproportionately enlarged subarachnoid space hydrocephalus (DESH).</p> Results <p>Thirty-one patients (37%) were classified as Suspected-iNPH, who were significantly older (p = <i>0.01</i>). No significant differences were found in pre- or postoperative JOA scores, and PROs. DESH was identified in 6 patients (7%), with 2 diagnosed as probable-iNPH based on cerebrospinal fluid tap tests.</p> Conclusions <p>A notable proportion of elderly DCM patients exhibit ventricular enlargement and DESH, suggesting a potential overlap with iNPH. Brain MRI should be considered for elderly DCM patients, particularly when neurological symptoms deviate from typical patterns.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Prevalence of idiopathic normal pressure hydrocephalus in patients with degenerative cervical myelopathy

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年5月28日

查看全文
  • Jim Yu,
  • Satoshi Kodama,
  • Koji Nakajima,
  • So Kato,
  • Hideki Nakamoto,
  • Hiroyasu Kodama,
  • Katsuyuki Sasaki,
  • Hiroyuki Nakarai,
  • Junya Miyahara,
  • Masashi Hamada,
  • Hirokazu Takami,
  • Hiroaki Abe,
  • Masahiko Sumitani,
  • Yuki Taniguchi,
  • Sakae Tanaka,
  • Yasushi Oshima

摘要

Purpose

Degenerative cervical myelopathy (DCM) and idiopathic normal pressure hydrocephalus (iNPH) share symptoms such as gait disturbance and urinary dysfunction, especially in the elderly. While the incidence of DCM in patients with iNPH is reported, the prevalence of iNPH in patients with DCM remains unclear. This study investigates the prevalence of iNPH in DCM patients.

Methods

This retrospective cohort study included 83 patients undergoing decompression surgery for DCM between April 2018 and March 2023. Brain MRI performed within three years prior to surgery was analyzed. Patients were categorized into two groups based on the Evans Index (EI): those with EI > 0.3 were classified as the Suspected-iNPH group, and those with EI ≤ 0.3 as the Non-iNPH group. Pre- and postoperative Japanese Orthopedic Association (JOA) scores and Patient-Reported Outcomes (PROs), including the Neck Disability Index (NDI), EuroQOL-5D (EQ-5D), Core Outcome Measure Index (COMI), and Numerical Rating Scale (NRS) for pain, were compared. Suspected-iNPH cases underwent further analysis to identify disproportionately enlarged subarachnoid space hydrocephalus (DESH).

Results

Thirty-one patients (37%) were classified as Suspected-iNPH, who were significantly older (p = 0.01). No significant differences were found in pre- or postoperative JOA scores, and PROs. DESH was identified in 6 patients (7%), with 2 diagnosed as probable-iNPH based on cerebrospinal fluid tap tests.

Conclusions

A notable proportion of elderly DCM patients exhibit ventricular enlargement and DESH, suggesting a potential overlap with iNPH. Brain MRI should be considered for elderly DCM patients, particularly when neurological symptoms deviate from typical patterns.