Diffusion Tensor Imaging Correlates with Short-Term Myelopathy Outcome in Patients with Cervical Spondylotic Myelopathy
| Autor: | Aditya Vedantam, Brian D. Schmit, Marjorie C. Wang, Michael B. Jirjis, Avinash Rao, Gerald Eckardt, Shekar N. Kurpad |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Cord SF-36 Sensitivity and Specificity 030218 nuclear medicine & medical imaging Cohort Studies 03 medical and health sciences Myelopathy 0302 clinical medicine Fractional anisotropy medicine Humans Prospective Studies Prospective cohort study medicine.diagnostic_test business.industry Reproducibility of Results Magnetic resonance imaging Middle Aged Prognosis medicine.disease Surgery Diffusion Tensor Imaging Treatment Outcome medicine.anatomical_structure Cervical Vertebrae Female Spondylosis Neurology (clinical) Nuclear medicine business 030217 neurology & neurosurgery Follow-Up Studies Cervical vertebrae Diffusion MRI |
| Zdroj: | World Neurosurgery. 97:489-494 |
| ISSN: | 1878-8750 |
| Popis: | 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 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. |
| Databáze: | OpenAIRE |
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