Relation between cervical and thoracic spinal canal stenosis and the development of spinal cord decompression sickness in recreational scuba divers.

Abstract:

STUDY DESIGN:Retrospective case-control study. OBJECTIVES:The intent of this study was to investigate the relationships between vertebral degenerative changes resulting in spinal canal stenosis, spinal cord lesions and the development of spinal cord decompression sickness (DCS) in scuba divers. SETTING:Referral hyperbaric facility, Toulon, France. METHODS:We examined 33 injured divers less than 50 years old by cervical and thoracic MRI and compared them with 34 matched control divers. The number of intervertebral disk abnormalities and the degree of canal compression were analyzed on T2-weighted sagittal images using a validated grading system developed recently. The presence and the distribution of hyperintense cord lesions in relation with the accident and the recovery status at 6 months were also assessed. RESULTS:Canal spinal narrowing was more common in injured divers than in controls (79% vs. 50%, OR=3.7 [95% CI, 1.3-10.8], P=0.021). We found a significant linear association between the extent of canal stenosis, multisegmental findings and the development of spinal cord decompression sickness. MRI intramedullary lesions were significantly more frequent in divers with incomplete recovery (OR=16 [95% CI, 2.6-99], P=0.0014), but statistical analysis failed to demonstrate a significant relationship between canal compression, signal cord abnormalities and a negative clinical outcome. CONCLUSIONS:These results suggest that divers with cervical and thoracic spinal canal stenosis, mainly due to disk degeneration, are at increased risk for the occurrence of spinal cord decompression sickness.

journal_name

Spinal Cord

journal_title

Spinal cord

authors

Gempp E,Louge P,Lafolie T,Demaistre S,Hugon M,Blatteau JE

doi

10.1038/sc.2013.121

subject

Has Abstract

pub_date

2014-03-01 00:00:00

pages

236-40

issue

3

eissn

1362-4393

issn

1476-5624

pii

sc2013121

journal_volume

52

pub_type

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