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- Title
Relation between cervical and thoracic spinal canal stenosis and the development of spinal cord decompression sickness in recreational scuba divers.
- Authors
Gempp, E; Louge, P; Lafolie, T; Demaistre, S; Hugon, M; Blatteau, J E
- Abstract
Study design:Retrospective case-control studyObjectives: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.
- Subjects
INTERVERTEBRAL disk abnormalities; CHI-squared test; CONFIDENCE intervals; DECOMPRESSION sickness; EPIDEMIOLOGY; FISHER exact test; MAGNETIC resonance imaging; SCUBA diving; SPINAL stenosis; T-test (Statistics); DATA analysis; CONTROL groups; RETROSPECTIVE studies; CASE-control method; DATA analysis software; DESCRIPTIVE statistics
- Publication
Spinal Cord, 2014, Vol 52, Issue 3, p236
- ISSN
1362-4393
- Publication type
Article
- DOI
10.1038/sc.2013.121