The purpose of this study is to use qualitative imaging analysis to determine if patients with multiple sclerosis (MS) have an increased likelihood of MS lesions at levels of existing cervical stenosis (CS).

The seminal paper on the relationship between MS and CS was published in 1957 by Brain and Wilkinson. Studies have since focused on whether surgical interventions are beneficial for MS patients, but only retrospective data of small cohorts exist, and their conclusions are mixed.

Forty-two comorbid MS and CS patients were identified via ICD codes and radiology reports. For each patient, axial and sagittal T2 sequences of cervical MRI scans were examined. The cord was split into 7 equal segments comprising the disc space and half of each adjacent vertebral body. Each segment was assessed for the presence of MS lesions and/or at least grade 2 CS by previously published criteria (Muhle et al, 1998). Lesions which were concerning for spondolytic-related signal change based on imaging characteristics were excluded (n=5, 5.3%). Clinical data was extracted from electronic medical records.

Average age at time of MRI was 56.6 +/- 9.2 years and average time with MS diagnosis was 13.3 +/- 9.0 years. The majority of patients suffered from RRMS (85.7%) and the F:M ratio was 3.6. Eighty-one percent of patients were on treatment at time of MRI, most often glatiramer acetate (33.3%). Spinal segments with at least grade 2 stenosis were significantly associated with the presence of an MS lesion in the same segment (χ²= 0.0120). This was also true for grade 3 stenosis (χ²= 0.0375). 

Our data suggest there is a significant association between segments of spinal cord with at least moderate CS and segments with MS lesions. Further studies to expand our cohort and include CS only control patients are planned.