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

作者：Vedantam Aditya; Rao Avinash; Kurpad Shekar N^*; Jirjis Michael B; Eckardt Gerald; Schmit Brian D; Wang Marjorie C

来源：World Neurosurgery, 2017, 97: 489-494.

DOI：10.1016/j.wneu.2016.03.075

• Cervical spine
• Diffusion tensor
• Diffusion tensor imaging
• Fractional anisotropy
• Magnetic resonance imaging
• Myelopathy
• Spondylosis

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.

• 出版日期2017-1