{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T05:28:24Z","timestamp":1792301304300,"version":"4.4.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,10,12]],"date-time":"2019-10-12T00:00:00Z","timestamp":1570838400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,10,12]],"date-time":"2019-10-12T00:00:00Z","timestamp":1570838400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100013651","name":"Deutsche Wirbels\u00e4ulenstiftung","doi-asserted-by":"crossref","award":["1\/2017"],"award-info":[{"award-number":["1\/2017"]}],"id":[{"id":"10.13039\/501100013651","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100002714","name":"Albert-Ludwigs-Universit\u00e4t Freiburg","doi-asserted-by":"publisher","award":["funding programme Open Access Publishing"],"award-info":[{"award-number":["funding programme Open Access Publishing"]}],"id":[{"id":"10.13039\/501100002714","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Orthop Surg Res"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n              <jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Increased spinal cord motion has been proven to be a relevant finding within spinal canal stenosis disclosed by phase-contrast MRI (PC-MRI). Adapted PC-MRI is a suitable and reliable method within the well deliberated setting. As the decision between conservative and operative treatment can be challenging in some cases, further diagnostic marker would facilitate the diagnostic process. We hypothesize that increased spinal cord motion will correlate to clinical course and functional impairment and will contribute as a new diagnostic marker.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A monocentric, prospective longitudinal observational trial on cervical spinal canal stenosis will be conducted at the University Medical Center Freiburg. Patients (<jats:italic>n<\/jats:italic>\u00a0=\u2009130) with relevant cervical spinal canal stenosis, being defined by at least contact to the spinal cord, will be included. Also, we will examine a control group of healthy volunteers (<jats:italic>n<\/jats:italic>\u00a0=\u200920) as proof-of-principle. We will observe two openly assigned branches of participants undergoing conservative and surgical decompressive treatment (based on current German Guidelines) over a time course of 12\u2009month, including a total of 4 visits. We will conduct a broad assessment of clinical parameters, standard scores and gradings, electrophysiological measurements, standard MRI, and adapted functional PC-MRI of spinal cord motion. Primary endpoint is the evaluation of an expected negative correlation of absolute spinal cord displacement to clinical impairment. Secondary endpoints are the evaluation of positive correlation of increased absolute spinal cord displacement to prolonged evoked potentials, prediction of clinical course by absolute spinal cord displacement, and demonstration of normalized spinal cord motion after decompressive surgery.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Discussion<\/jats:title>\n                <jats:p>With the use of adapted, non-invasive PC-MRI as a quantitative method for assessment of spinal cord motion, further objective diagnostic information can be gained, that might improve the therapeutic decision-making process. This study will offer the needed data in order to establish PC-MRI on spinal cord motion within the diagnostic work-up of patients suffering from spinal canal stenosis.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Trial registration<\/jats:title>\n                <jats:p>German Clinical Trials Register, ID: <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.drks.de\/drks_web\/navigate.do?navigationId=trial.HTML&amp;TRIAL_ID=DRKS00012962\">DRKS00012962<\/jats:ext-link>, Register date 2018\/01\/17<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13018-019-1381-9","type":"journal-article","created":{"date-parts":[[2019,10,12]],"date-time":"2019-10-12T07:38:14Z","timestamp":1570865894000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Assessment of spinal cord motion as a new diagnostic MRI-parameter in cervical spinal canal stenosis: study protocol on a prospective longitudinal trial"],"prefix":"10.1186","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1468-3634","authenticated-orcid":false,"given":"Katharina","family":"Wolf","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel J.","family":"Krafft","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karl","family":"Egger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Helge","family":"Klingler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Hubbe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Reisert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Hohenhaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,10,12]]},"reference":[{"issue":"12","key":"1381_CR1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000913","volume":"40","author":"A Nouri","year":"2015","unstructured":"Nouri A, Tetreault L, Singh A, Karadimas SK, Fehlings MG. Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis. Spine. 2015;40(12):E675.","journal-title":"Spine"},{"issue":"5","key":"1381_CR2","doi-asserted-by":"publisher","first-page":"1015","DOI":"10.1002\/jmri.23632","volume":"36","author":"M Markl","year":"2012","unstructured":"Markl M, Frydrychowicz A, Kozerke S, Hope M, Wieben O. 4D flow MRI. J Magn Reson Imaging. 2012;36(5):1015.","journal-title":"J Magn Reson Imaging"},{"key":"1381_CR3","doi-asserted-by":"publisher","unstructured":"Dyverfeldt P, Bissel M, Barker AJ, Boler AF, Carlh\u00e4ll CJ, et al. 4D flow cardiovascular magnetic resonance consensus statement. J Cardiovasc Magn Reson. 2015. \n                    https:\/\/doi.org\/10.1186\/s12968-015-0174-5\n                    \n                  .","DOI":"10.1186\/s12968-015-0174-5"},{"key":"1381_CR4","doi-asserted-by":"publisher","first-page":"623","DOI":"10.3174\/ajnr.A4030","volume":"36","author":"A Yamada","year":"2015","unstructured":"Yamada A, Tsuchiya K, Bradley WG, Law M, Winkler ML, Borzage MR, et al. Current and emerging MR imaging techniques for the diagnosis and management of CSF flow disorders: a review of phase-contrast and time-spatial labeling inversion pulse. Am J Neuroradiol. 2015;36:623.","journal-title":"Am J Neuroradiol"},{"key":"1381_CR5","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1148\/radiology.217.3.r00dc42877","volume":"217","author":"NJ Alperin","year":"2000","unstructured":"Alperin NJ, Lee SH, Loth F, Raksin PB, Lichtor T. MR-intracranial pressure (ICP): a method to measure intracranial elastance and pressure noninvasively by means of MR imaging: baboon and human study. Radiology. 2000;217:877.","journal-title":"Radiology"},{"key":"1381_CR6","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1002\/mrm.22907","volume":"66","author":"J Bock","year":"2011","unstructured":"Bock J, Frydrychowicz A, Lorenz R, Hirtler D, Barker AJ, Johnson KM, et al. In vivo noninvasive 4D pressure difference mapping in the human aorta: phantom comparison and application in healthy volunteers and patients. Magn Reson Med. 2011;66:1079.","journal-title":"Magn Reson Med"},{"key":"1381_CR7","doi-asserted-by":"publisher","first-page":"349","DOI":"10.1002\/mrm.22202","volume":"63","author":"KM Johnson","year":"2010","unstructured":"Johnson KM, Markl M. Improved SNR in phase contrast velocimetry with five-point balanced flow encoding. Magn Reson Med. 2010;63:349.","journal-title":"Magn Reson Med"},{"key":"1381_CR8","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1016\/B978-0-444-53485-9.00028-3","volume":"135","author":"WG Bradley","year":"2016","unstructured":"Bradley WG, Haughton V, Mardal KA. Cerebrospinal fluid flow in adults. Hand Clin Neurol. 2016;135:591.","journal-title":"Hand Clin Neurol"},{"key":"1381_CR9","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1053\/j.sult.2016.01.002","volume":"37","author":"EJ Kelly","year":"2016","unstructured":"Kelly EJ, Yamada S. Cerebrospinal fluid flow studies and recent advancements. Semin Ultrasound CT MRI. 2016;37:92.","journal-title":"Semin Ultrasound CT MRI"},{"issue":"7","key":"1381_CR10","first-page":"760","volume":"56","author":"K Wolf","year":"2018","unstructured":"Wolf K, Hupp M, Friedl S, Sutter R, Klarh\u00f6fer M, Grabher P, et al. In cervical spondylotic myelopathy spinal cord motion is focally increased at the level of stenosis: a controlled cross-sectional study. Spinal Cord. 2018;56(7):760.","journal-title":"Spinal Cord"},{"issue":"10","key":"1381_CR11","doi-asserted-by":"publisher","first-page":"2344","DOI":"10.1016\/j.spinee.2014.01.036","volume":"14","author":"IM Vavasour","year":"2013","unstructured":"Vavasour IM, Meyers SM, MacMillan EL, M\u00e4dler B, Li DK, Rauscher A, et al. Increased spinal cord movements in cervical spondylotic myelopathy. Spine J. 2013;14(10):2344.","journal-title":"Spine J"},{"issue":"26","key":"1381_CR12","doi-asserted-by":"publisher","first-page":"2136","DOI":"10.1097\/BRS.0000000000000607","volume":"39","author":"HS Chang","year":"2014","unstructured":"Chang HS, Nejo T, Yoshida S, Oya S, Matsiu T. Increased flow signal in compressed segments of the spinal cord in patients with cervical spondylotoc myelopathy. Spine. 2014;39(26):2136.","journal-title":"Spine"},{"key":"1381_CR13","unstructured":"DGN. \n                    https:\/\/www.dgn.org\/leitlinien\/3423-030-052-zervikale-spondylotische-myelopathie-2017#therapie\n                    \n                  . Accessed 25 Feb 2019."},{"issue":"4","key":"1381_CR14","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0123022","volume":"10","author":"S Kato","year":"2015","unstructured":"Kato S, Oshima Y, Oka H, Chikuda H, Takeshita Y, Miyoshi K, et al. Comparison of the Japanese Orthopaedic Association (JOA) score and modified JOA (mJOA) score for the assessment of cervical myelopathy: a multicenter observational study. PLoS One. 2015;10(4):e0123022.","journal-title":"PLoS One"},{"issue":"1","key":"1381_CR15","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1093\/brain\/95.1.87","volume":"95","author":"S Nurick","year":"1972","unstructured":"Nurick S. The pathogenesis of the spinal cord disorder associated with cervical spondylosis. Brain J Neurol. 1972;95(1):87.","journal-title":"Brain J Neurol"},{"issue":"6","key":"1381_CR16","doi-asserted-by":"publisher","first-page":"547","DOI":"10.1179\/107902611X13186000420242","volume":"34","author":"SF Kirshblum","year":"2011","unstructured":"Kirshblum SF, Warun W, Biering-Sorensen F, Burns SP, Johansen M, Schmidt-Read M, et al. Reference for the 2011 revision of the international standard for neurological classification of spinal cord injury. J Spinal Cord Med. 2011;34(6):547.","journal-title":"J Spinal Cord Med"},{"key":"1381_CR17","doi-asserted-by":"crossref","unstructured":"Buchner, H: Praxisbuch Evozierte Potenziale: Grundlagen, Befundung, Beurteilung und differenzialdiagnostische Abgrenzung. 1. Aufl. Thieme; 2014.","DOI":"10.1055\/b-002-95262"},{"issue":"10","key":"1381_CR18","doi-asserted-by":"publisher","first-page":"1829","DOI":"10.1089\/neu.2011.2277","volume":"29","author":"F Kuhn","year":"2012","unstructured":"Kuhn F, Halder P, Spiess MR, Schubert M, EM-SCI Study Group. One-year evolution of ulnar somatosensory potentials after trauma in 365 tetraplegic patients: early prediction of potential upper limb function. J Neurotrauma. 2012;29(10):1829.","journal-title":"J Neurotrauma"},{"issue":"8","key":"1381_CR19","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1177\/1545968312438437","volume":"26","author":"JA Petersen","year":"2012","unstructured":"Petersen JA, Spiess M, Curt A, Dietz V, Schubert M, EM-SCI Study Group. Spinal cord injury: one-year evolution of motor-evoked potentials and recovery of leg motor function in 255 patients. Neurorehabil Neural Repair. 2012;26(8):939.","journal-title":"Neurorehabil Neural Repair"},{"issue":"5","key":"1381_CR20","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1002\/jmri.21561","volume":"28","author":"B Jung","year":"2008","unstructured":"Jung B, Ullmann P, Honal M, Bauer S, Hennig J, Markl M. Parallel MRI with extended and averaged GRAPPA kernels (PEAK-GRAPPA): optimized spatiotemporal dynamic imaging. J Magn Reson Imaging. 2008;28(5):1226.","journal-title":"J Magn Reson Imaging"},{"issue":"1","key":"1381_CR21","doi-asserted-by":"publisher","first-page":"59","DOI":"10.3171\/2009.5.SPINE08940","volume":"12","author":"M Yagi","year":"2010","unstructured":"Yagi M, Ninomiya K, Kihara M, et al. Long-term surgical outcome and risk factors in patients with cervical myelopathy and a change in signal intensity of intramedullary spinal cord on magnetic resonance imaging. J Neurosurg Spine. 2010;12(1):59.","journal-title":"J Neurosurg Spine"},{"issue":"1","key":"1381_CR22","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1148\/radiol.2291020658","volume":"229","author":"A Demir","year":"2003","unstructured":"Demir A, Ries M, Moonen CTW, et al. Diffusion-weighted MR imaging with apparent diffusion coefficient and apparent diffusion tensor maps in cervical spondylotic myelopathy. Radiology. 2003;229(1):37.","journal-title":"Radiology"},{"issue":"2","key":"1381_CR23","doi-asserted-by":"publisher","first-page":"420","DOI":"10.1037\/0033-2909.86.2.420","volume":"86","author":"PE Shrout","year":"1979","unstructured":"Shrout PE, Fleiss JL. Intraclass correlations: use in assessing rater reliability. Psych Bulletin. 1979;86(2):420.","journal-title":"Psych Bulletin"},{"issue":"6","key":"1381_CR24","doi-asserted-by":"publisher","DOI":"10.3171\/2016.3.FOCUS1667","volume":"40","author":"A Nouri","year":"2016","unstructured":"Nouri A, Marin AR, Mikulis D, Fehlings MG. Magnetic resonance imaging assessment of degenerative cervical myelopathy: a review of structural changes and measurement techniques. Neurosurg Focus. 2016;40(6):E5.","journal-title":"Neurosurg Focus"},{"issue":"1","key":"1381_CR25","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1002\/mrm.21260","volume":"58","author":"CR Figley","year":"2007","unstructured":"Figley CR, Stroman PW. Investigation of human cervical and upper thoracic spinal cord motion: implications for imaging spinal cord structure and function. Magn Reson Med. 2007;58(1):185.","journal-title":"Magn Reson Med"},{"issue":"7","key":"1381_CR26","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1038\/sc.1996.75","volume":"34","author":"H Matsuzaki","year":"1996","unstructured":"Matsuzaki H, Wakabayashi K, Ishihara K, Ishikawa H, Kawabata H, Onomura T. The origin and significance of spinal cord pulsation. Spinal Cord. 1996;34(7):422.","journal-title":"Spinal Cord"},{"issue":"3","key":"1381_CR27","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1097\/00004424-199803000-00003","volume":"33","author":"H Tanaka","year":"1998","unstructured":"Tanaka H, Sakurai K, Kshiwagi N, Fujita N, Hirabuki N, Inaba F, et al. Transition of the craniocaudal velocity of the spinal cord: from cervical segment to lumbar enlargement. Investig Radiol. 1998;33(3):141.","journal-title":"Investig Radiol"},{"key":"1381_CR28","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1227\/01.NEU.0000215383.64386.82","volume":"60","author":"EM Baron","year":"2007","unstructured":"Baron EM, Young WF. Cervical spondylotic myelopathy: a brief review of its pathophysiology, clinical course, and diagnosis. Neurosurgery. 2007;60:35.","journal-title":"Neurosurgery"},{"issue":"5","key":"1381_CR29","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1007\/BF00596493","volume":"34","author":"D Greitz","year":"1992","unstructured":"Greitz D, Wirestam R, Franck A, Nordell B, Thomsen C, Sthalberg F. Pulsatil brain movement and associated hydrondynamics studies by magnetic resonance phase imaging. The Monro-Kellie doctrine revisited. Neuroradiology. 1992;34(5):370.","journal-title":"Neuroradiology"}],"container-title":["Journal of Orthopaedic Surgery and Research"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-019-1381-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s13018-019-1381-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s13018-019-1381-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,10,10]],"date-time":"2020-10-10T23:10:38Z","timestamp":1602371438000},"score":1,"resource":{"primary":{"URL":"https:\/\/josr-online.biomedcentral.com\/articles\/10.1186\/s13018-019-1381-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,12]]},"references-count":29,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2019,12]]}},"alternative-id":["1381"],"URL":"https:\/\/doi.org\/10.1186\/s13018-019-1381-9","relation":{},"ISSN":["1749-799X"],"issn-type":[{"value":"1749-799X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,12]]},"assertion":[{"value":"29 July 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 September 2019","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 October 2019","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Approval by the ethics committee of the Albert-Ludwigs-University Freiburg (ID 261\/17).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Consent for publication is given by all authors and the patients, whose MRI-data is exemplarily demonstrated.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"321"}}