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Diffusion Tensor Imaging Correlates with Short-Term Myelopathy Outcome in Patients with Cervical Spondylotic Myelopathy. World Neurosurg 2017 Jan;97:489-494

Date

04/06/2016

Pubmed ID

27046013

DOI

10.1016/j.wneu.2016.03.075

Scopus ID

2-s2.0-84995873439   15 Citations

Abstract

OBJECTIVE: To determine if spinal cord diffusion tensor imaging indexes correlate with short-term clinical outcome in patients undergoing elective cervical spine surgery for cervical spondylotic myelopathy (CSM).

METHODS: A prospective consecutive cohort study was performed in patients undergoing elective cervical spine surgery for CSM. After obtaining informed consent, patients with CSM underwent preoperative T2-weighted magnetic resonance imaging and diffusion tensor imaging of the cervical spine. Fractional anisotropy (FA) values at the level of maximum cord compression and at the noncompressed C1-2 level were calculated on axial images. We recorded the modified Japanese Orthopaedic Association (mJOA) scale, Neck Disability Index, and Short Form-36 physical functioning subscale scores for all patients preoperatively and 3 months postoperatively. Statistical analysis was performed to identify correlations between FA and clinical outcome scores.

RESULTS: The study included 27 patients (mean age 54.5 years ± 1.9, 12 men). The mean postoperative changes in mJOA scale, Neck Disability Index, and Short Form-36 physical functioning subscale scores were 0.9 ± 0.3, -6.0 ± 1.9, and 3.4 ± 1.9. The mean FA at the level of maximum compression was significantly lower than the mean FA at the C1-2 level (0.5 vs. 0.55, P = 0.01). FA was significantly correlated with change in mJOA scale score (Pearson r = -0.42, P = 0.02). FA was significantly correlated with the preoperative mJOA scale score (Pearson r = 0.65, P < 0.001).

CONCLUSIONS: Preoperative FA at the level of maximum cord compression significantly correlates with the 3-month change in mJOA scale score among patients with CSM. FA was also significantly associated with preoperative mJOA scale score and is a potential biomarker for spinal cord dysfunction in CSM.

Author List

Vedantam A, Rao A, Kurpad SN, Jirjis MB, Eckardt G, Schmit BD, Wang MC

Authors

Shekar N. Kurpad MD, PhD Chair, Professor in the Neurosurgery department at Medical College of Wisconsin
Brian Schmit PhD Professor in the Biomedical Engineering department at Marquette University
Marjorie Wang MD Chief, Professor in the Neurosurgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Cervical Vertebrae
Cohort Studies
Diffusion Tensor Imaging
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prognosis
Prospective Studies
Reproducibility of Results
Sensitivity and Specificity
Spondylosis
Treatment Outcome