Comparison of Cervical Cerebrospinal Fluid Flow Quantification between Healthy Volunteers and Patients with Spinal Stenosis

We measured spinal CSF velocity in healthy volunteers and patients with spinal stenosis secondary to degenerative changes of the spine. A total of 122 subjects: 33 healthy volunteers and 89 patients with neck and shoulder pain were examined. Flow quantification was obtained using cine phase-contrast sequence and flow analysis software at C7 level. The symptomatic patients were graded into three groups according to the visual degree of stenosis. In addition, all subjects were divided into three index groups dividing the dural sac area from the cord area at C7 level in the healthy volunteers, and at the most prominent stenotic level in the patient group. Subarachnoidal space index was also calculated by subtracting the cord area from the dural sac area at the same levels. The maximum systolic velocities in front of the cord at C7 level were measured between 4.6 and 31.7 (average: 17.2 ± 7.4) cm/s in the volunteer group and 4.5 and 41.6 (average: 16.1 ± 6.8) cm/s in the patient group, whereas the maximum diastolic velocities were calculated between 3.1 to 28.5 (15.1 ± 7.5) cm/s in the volunteer group and 1.5 to 40.3 (14.5 ± 7.4) cm/s in the patients respectively. Systolic average velocities were 2.9 – 10.6 (average: 6.1 ± 2.2) cm/s in the volunteers and 1.7 – 17.8 (6.6 ± 2.9) cm/s in the patients; corresponding diastolic average velocities were 0.6 – 11.9 (4.7 ± 2,4) cm/s and 0.4 – 14,9 (4.9 ± 2.8) cm/s. Systolic flow rates were 17.5 – 82.6 (34.3 ± 10.7) ml/min in the volunteers and 5.5 – 104.2 (36.0 + 19.5) ml/min in the patient group whereas diastolic flow rates were 3.5 – 78.4 (29.0 ± 15.1) ml/min and 1.6 – 75.6 (26.2 ± 15.4) ml/min. No statistically significant difference was found between the CSF flow patterns, CSF velocities and flow rates at the C7 anterior subarachnoid space in healthy subjects and patients with spinal stenosis.