Diffusion Tensor Imaging Correlates with Short-Term Myelopathy Outcome in Patients with Cervical Spondylotic Myelopathy.

Autor: Vedantam A; Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA., Rao A; University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA., Kurpad SN; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. Electronic address: skurpad@mcw.edu., Jirjis MB; Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, USA., Eckardt G; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Schmit BD; Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, USA., Wang MC; University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2017 Jan; Vol. 97, pp. 489-494. Date of Electronic Publication: 2016 Mar 30.
DOI: 10.1016/j.wneu.2016.03.075
Abstrakt: 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.
(Published by Elsevier Inc.)
Databáze: MEDLINE
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