Cervical Spinal Cord Signal Abnormalities in Patients With Cervical Radicular Pain

N/ANot Yet RecruitingNCT07823426

Ankara City Hospital Bilkent400 enrolled

Overview

This prospective observational study aims to determine the prevalence of cervical spinal cord signal abnormalities, including myelomalacia, among adult patients presenting to a tertiary pain clinic with cervical radicular pain. A total of 400 consecutive patients will be enrolled. Clinical and neurological examination findings, including the Hoffmann sign and other findings suggestive of cervical spinal cord involvement, will be recorded together with cervical magnetic resonance imaging (MRI) findings obtained as part of routine clinical care. The primary outcome is the prevalence of cervical spinal cord signal abnormalities, including myelomalacia, on cervical MRI. Secondary outcomes include the treatment strategy selected during routine clinical care, clinical and radiological factors associated with treatment selection, the relationship between the Hoffmann sign and cervical spinal cord abnormalities, and referral for surgical evaluation. This is an observational study. Participation in the study will not determine or alter diagnostic or treatment decisions, which will be made by the treating physician according to routine clinical practice.

Study Type

OBSERVATIONAL

Enrollment

400

Conditions

Cervical Radiculopathy Cervical Myelomalacia

Interventions

Participants will undergo routine clinical and neurological evaluation, including assessment of the Hoffmann sign and other neurological findings, together with evaluation of cervical magnetic resonance imaging (MRI) findings. Cervical MRI findings, including spinal canal stenosis, spinal cord compression, intramedullary signal abnormalities, and myelomalacia, will be recorded. All assessments are performed as part of routine clinical care. No diagnostic procedure or treatment is assigned by the study protocol.

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * Age 18 years or older * Presentation to the pain clinic with cervical radicular pain * Clinical symptoms and/or examination findings consistent with cervical nerve root involvement * Availability of a cervical magnetic resonance imaging (MRI) examination suitable for evaluation * Completion of standardized neurological examination at the initial visit * Ability and willingness to provide written informed consent Exclusion Criteria: * Previous cervical spine surgery * Acute cervical spine trauma * Known cervical spinal malignancy * Active spinal infection * Known inflammatory, demyelinating, or other non-degenerative spinal cord disease * Severe cognitive impairment or communication difficulty preventing reliable clinical assessment * Inadequate or non-diagnostic cervical MRI quality * Refusal to participate

Outcomes

Primary Outcomes

Prevalence of Cervical Spinal Cord Signal Abnormalities Including Myelomalacia

The proportion of participants with cervical spinal cord signal abnormalities identified on cervical magnetic resonance imaging (MRI), including intramedullary T2-weighted signal abnormalities and findings consistent with myelomalacia, will be determined. The prevalence will be calculated as the number of participants with these MRI findings divided by the total number of enrolled participants with evaluable cervical MRI examinations.