OBJECTIVES To answer the question whether cervical spondylosis would increase the incidence of cord lesions in MS patients, we investigated the statistical association between the two pathologies. METHODS We extracted demographics, basic disease characteristics and MRI data of a cohort of 304 consecutive MS patients. For a subset of 176 patients, a detailed analysis independently assessed for each cervical level the co-existence of spinal canal narrowing from spondylosis and corresponding cord signal abnormalities. RESULTS The cohort had typical demographics and in over 80 % of cases there was at least one cord lesion. EDSS correlated with age, disease duration, cerebral lesion burden and spinal cord lesions. After adjusting for either age, disease duration, central lesion burden, or EDSS, the presence of spinal spondylosis was not significantly associated with spinal cord lesions (p > 0.05). In the subset of 176 subjects with the level-by-level spine data, we found a highly statistically significant association (Pearson's χ2 = 23.7, p < 0.001) between canal narrowing and cord lesion at the level directly above or below. This association remained highly significant in both univariable and multivariable logistic regression models adjusting for age, disease duration, MS treatment, cerebral lesion burden and disability scores (p < 0.001). CONCLUSIONS The data from our cohort of MS patients suggest an indirect contribution of cervical spondylosis to disability by increasing the risk of developing localized cord lesions. While further studies are needed to confirm the findings and clarify disease mechanisms, closer attention should be paid to worsening spondylosis in patients with MS.

中文翻译：

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颈椎病是多发性硬化症局部脊髓病变的危险因素

目的 为了回答颈椎病是否会增加 MS 患者脊髓损伤的发生率这一问题，我们调查了这两种病理之间的统计关联。方法我们提取了 304 名连续多发性硬化症患者队列的人口统计学、基本疾病特征和 MRI 数据。对于 176 名患者的子集，详细分析独立评估了每个颈椎水平的椎管变窄与相应脊髓信号异常的共存情况。结果 该队列具有典型的人口统计学特征，并且在超过 80% 的病例中至少有一处脊髓损伤。EDSS 与年龄、病程、脑损伤负荷和脊髓损伤相关。在调整年龄、病程、中心病变负荷或 EDSS 后，脊椎病的存在与脊髓病变没有显着相关性（p > 0.05）。在具有逐级脊柱数据的 176 名受试者的子集中，我们发现根管狭窄与直接高于或低于水平的脊髓损伤之间存在高度统计学显着性关联（Pearson χ2 = 23.7，p < 0.001）。这种关联在调整年龄、病程、MS 治疗、脑损伤负担和残疾评分的单变量和多变量逻辑回归模型中仍然非常显着（p < 0.001）。结论 来自我们 MS 患者队列的数据表明，颈椎病通过增加发生局部脊髓病变的风险间接导致了残疾。虽然需要进一步的研究来证实这些发现并阐明疾病机制，