Background: Degenerative cervical myelopathy is
characterized by progressive compression of the spinal cord resulting in
debilitating loss of dexterity, independent ambulation, and sphincter
control. Diffusion tensor imaging (DTI) has shown that, compared to healthy
controls, myelopathy patients have decreased integrity of the corticospinal
tracts and corpus callosum (Bernabeu-Sanz et al, 2020).
Methods: Twenty-six myelopathy patients consented
to cerebral diffusion tensor imaging (3 Tesla, 32 directions, b=1000)
preoperatively, as well as 6-weeks, 12-weeks, and 6-months postoperatively.
Average mean diffusivity (MD), fractional anisotropy (FA), radial
diffusivity (RD), and axial diffusivity (AD) were measured in the
corticospinal tracts, forceps major, and forceps minor.
Results: Both MD and RD decreased from 6-12 weeks
postoperatively in the right corticospinal tract. The forceps major of the
corpus callosum showed an initial postoperative increase in MD followed by a
subsequent increase in FA and decrease in RD 3-6 months postoperatively. The
AD of the forceps major increased both immediately and 3-6 months
postoperatively. Conclusions: Changes in
microstructural integrity of the corticospinal tract and forceps major over
the postoperative recovery period suggest a pattern of recovery in
myelopathy patients. This study is the first to report postoperative DTI
changes in myelopathy-relevant white matter tracts in the brain.
P.172 Diffusion MRI characteristics change in select cerebral white
matter tracts after decompressive surgery for degenerative cervical
myelopathy