Barzilai University Medical Center

47 Research Day 2020 Barzilai University Medical Center 29 IS CERVICAL DISC DISEASE ASSOCIATED WITH DEMYELINATING LESIONS IN MULTIPLE SCLEROSIS? Marwan Alkrenawi 1 , Shmuel Appel 1, 3 , Michael Osherov 1 , Azaria Simonovich 2, 3 , Jonathan Droujin 2 , Ron Milo 1, 3 Department of 1 Neurology and Radiology 1 , Barzilai University Medical Center, Ashkelon; 3 Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva Background Multiple sclerosis (MS) is characterized by demyelinating lesions in the brain and spinal cord. Early studies suggested that disc herniation may contribute to the development of cord lesions in MS. Hypothesis Cervical disc disease may induce MS lesions in the spinal cord of MS patients. Objective To check whether cervical spinal disc disease is associated with demyelinating lesions in the spinal cord. Methods Cervical MRI scans of 47 MS patients were reviewed for the presence of demyelinating lesion and cervical disc disease. Compressive-myelopathic lesions were excluded. The severity of the disc disease was further classified as grade I (no pressure), grade II (pressure on the dural sac) and grade III (pressure on the spinal cord). The spinal cord in each scan was divided into 6 segments corresponding to the intervertebral space of the cervical cord (C1-7). Each segment was defined as containing a demyelinating lesion and disc pathology (group 1), demyelinating lesion without disc pathology (group 2), disc pathology without demyelinating lesion (group 3) and no demyelinating lesion or disc pathology (group 4). Fisher exact test was used to test the association between demyelinating lesions and disc herniation. Results Two hundred and eighty-two cervical spinal segments of 47 MS patients (M-16, average age 47.8±12.5, average disease duration 8.2±5.6 years) were evaluated. Twenty-four segments fulfilled the criteria for group1, 55 segments for group 2, 52 segments for group 3 and 151 segments for group 4. There was no association between demyelinating lesions and the grade of disc disease (p=0.45 for grade I, p=0.85 for grade II, p=0.33 for grade III disc disease). Conclusion Our study did not find any association between cervical disc disease and demyelinating spinal cord lesion and does not suggest herniated disc as a trigger for developing demyelinating lesions in the spinal cord.