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Objective.  To evaluate the forward shifting of cervical spinal cords in different segments of patients with Hirayama disease to determine whether the disease is self-limiting.  Methods.  This study was performed on 11 healthy subjects and 64 patients. According to the duration, the patients were divided into 5 groups (≤1 year, 1-2 years, 2-3 years, 3-4 years, and ≥4 years). Cervical magnetic resonance imaging (MRI) of flexion and conventional position was performed. The distances between the posterior edge of the spinal cord and the cervical spinal canal ( X ), the anterior and posterior wall of the cervical spinal canal ( Y ), and the anterior-posterior ( A ) and the transverse diameter ( B ) of spinal cord cross sections were measured at different cervical spinal segments (C4 to T1).  Results.  In cervical flexion position, a significant increase in  X / Y  of C4-5 segments was found in groups 2–5, the C5-6 and C6-7 segments in groups 1–5, and the C7-T1 segments in group 5 ( P  < 0.05). The degree of the increased  X / Y  and cervical flexion  X / Y  of C5-6 segments were different among the 5 groups ( P  < 0.05), which was likely due to rapid increases in  X / Y  during the course of Hirayama's disease.  Conclusion.  The  X / Y  change progression indicates that Hirayama disease may not be self-limiting.

The Quantitative Assessment of Imaging Features for the Study of Hirayama Disease Progression