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A population-based magnetic resonance imaging (MRI) study of the cervical spine.This study was undertaken in order to investigate the prevalence of cervical cord compression (CCC) and to examine the association between CCC and physical performance measures in a population-based cohort established in Japan.Population-based cohort studies of the prevalence of CCC, although essential for clarification of the prevalence of slowly progressive disease and specification of the time of incidence of CCC, are not available.This cross-sectional study was performed as a part of the Research on Osteoarthritis/osteoporosis Against Disability study, a large-scale population-based cohort study in Japan. From 1011 inhabitants who underwent MRI examinations, images of the cervical spine of 977 subjects (324 men and 653 women, mean age of 66.4 yr) were evaluated. CCC was assessed by sagittal T2-weighted MRI and was defined as spinal cord compression. The prevalence of CCC and its association with myelopathic signs (hyper-reflexia of the patellar tendon and Hoffmann and Babinski reflexes) were examined. In addition, physical performance measures (grip and release test, grip strength, 6-m walking time, step length, chair-stand time, and one-leg standing time) were tested.The prevalence of CCC was 24.4% and was significantly higher in men (29.3% in men and 21.9% in women, P = 0.011). The prevalence of CCC was higher with increasing age in both sexes. CCC was not significantly associated with any myelopathic signs but was significantly associated with grip and release test, 6-m walking time, step length, and chair-stand time.In this MRI study, the prevalence of CCC was examined. The present results indicate that CCC correlates with physical performance measures from an early stage of the disease before myelopathic signs appear.