Prevalence of idiopathic normal pressure hydrocephalus in patients with degenerative cervical myelopathy

Jim Yu; Satoshi Kodama; Koji Nakajima; So Kato; Hideki Nakamoto; Hiroyasu Kodama; Katsuyuki Sasaki; Hiroyuki Nakarai; Junya Miyahara; Masashi Hamada; Hirokazu Takami; Hiroaki Abe; Masahiko Sumitani; Yuki Taniguchi; Sakae Tanaka; Yasushi Oshima

doi:10.1007/s00586-025-08945-3

Back

Prevalence of idiopathic normal pressure hydrocephalus in patients with degenerative cervical myelopathy

Journal article

Peer reviewed

Prevalence of idiopathic normal pressure hydrocephalus in patients with degenerative cervical myelopathy

Jim Yu, Satoshi Kodama, Koji Nakajima, So Kato, Hideki Nakamoto, Hiroyasu Kodama, Katsuyuki Sasaki, Hiroyuki Nakarai, Junya Miyahara, Masashi Hamada, …

European spine journal, Vol.34(8), pp.3243-3252

08/01/2025

DOI: 10.1007/s00586-025-08945-3

PMID: 40434581

Files and links (1)

url

https://doi.org/10.1007/s00586-025-08945-3View

Published (Version of record) Open Access

Abstract

Purpose Degenerative cervical myelopathy (DCM) and idiopathic normal pressure hydrocephalus (iNPH) share symptoms such as gait disturbance and urinary dysfunction, especially in the elderly. While the incidence of DCM in patients with iNPH is reported, the prevalence of iNPH in patients with DCM remains unclear. This study investigates the prevalence of iNPH in DCM patients. Methods This retrospective cohort study included 83 patients undergoing decompression surgery for DCM between April 2018 and March 2023. Brain MRI performed within three years prior to surgery was analyzed. Patients were categorized into two groups based on the Evans Index (EI): those with EI > 0.3 were classified as the Suspected-iNPH group, and those with EI <= 0.3 as the Non-iNPH group. Pre- and postoperative Japanese Orthopedic Association (JOA) scores and Patient-Reported Outcomes (PROs), including the Neck Disability Index (NDI), EuroQOL-5D (EQ-5D), Core Outcome Measure Index (COMI), and Numerical Rating Scale (NRS) for pain, were compared. Suspected-iNPH cases underwent further analysis to identify disproportionately enlarged subarachnoid space hydrocephalus (DESH). Results Thirty-one patients (37%) were classified as Suspected-iNPH, who were significantly older (p = 0.01). No significant differences were found in pre- or postoperative JOA scores, and PROs. DESH was identified in 6 patients (7%), with 2 diagnosed as probable-iNPH based on cerebrospinal fluid tap tests. Conclusions A notable proportion of elderly DCM patients exhibit ventricular enlargement and DESH, suggesting a potential overlap with iNPH. Brain MRI should be considered for elderly DCM patients, particularly when neurological symptoms deviate from typical patterns.

Clinical Neurology

Life Sciences & Biomedicine

Neurosciences & Neurology

Orthopedics

Science & Technology

Details

Title: Subtitle: Prevalence of idiopathic normal pressure hydrocephalus in patients with degenerative cervical myelopathy
Creators: Jim Yu - University of Tokyo Hospital
Satoshi Kodama - The University of Tokyo
Koji Nakajima - University of Tokyo Hospital
So Kato - University of Tokyo Hospital
Hideki Nakamoto - University of Tokyo Hospital
Hiroyasu Kodama - University of Tokyo Hospital
Katsuyuki Sasaki - University of Tokyo Hospital
Hiroyuki Nakarai - University of Tokyo Hospital
Junya Miyahara - University of Tokyo Hospital
Masashi Hamada - University of Tokyo Hospital
Hirokazu Takami - University of Tokyo Hospital
Hiroaki Abe - University of Tokyo Hospital
Masahiko Sumitani - University of Tokyo Hospital
Yuki Taniguchi - University of Tokyo Hospital
Sakae Tanaka - University of Tokyo Hospital
Yasushi Oshima - University of Tokyo Hospital
Resource Type: Journal article
Publication Details: European spine journal, Vol.34(8), pp.3243-3252
DOI: 10.1007/s00586-025-08945-3
PMID: 40434581
ISSN: 0940-6719
eISSN: 1432-0932
Publisher: Springer Nature
Number of pages: 10
Grant note: University of Tokyo
Language: English
Date published: 08/01/2025
Academic Unit: Neurology
Record Identifier: 9985177945702771

Metrics

1 Record Views