Chronic cervical compressive myelopathy in horses: clinical correlations with spinal cord alterations

Object This study was conducted to determine whether postoperative changes in the fractional anisotropy (FA) value and diffusion tensor imaging of the cervical spinal cord can predict functional outcome for patients with cervical compressive myelopathy (CCM). Methods Twenty patients with CCM were treated by laminoplasty from 2008 to 2009. Both T2-weighted MRI and diffusion tensor imaging were performed before and after surgery. The FA values were analyzed and fiber tracking was performed. The fiber tract (FT) ratio was calculated according to the following formula: (number of fibers at the compressed level)/(number of fibers at the C-2 level) × 100%. The Japanese Orthopaedic Association scoring system for cervical myelopathy was used to determine pre- and postoperative neurological status of the patients, and the Hirabayashi method was used to calculate the recovery rate. Results There was no significant difference in recovery rates between patients with and those without intramedullary high signal intensity on preoperative T2-weighted images. Substantial differences in FA value among spinal cord, bone, and CSF made it difficult to obtain a precise FA value for the compressed spinal cord. There was a significant correlation between the preoperative FT ratio and the recovery rate (p = 0.0006). A poor outcome (recovery rate < 40%) could be anticipated for CCM patients with preoperative FT ratios below 60%. Conclusions The preoperative FT ratio correlated significantly with the recovery rates in CCM patients. Preoperative diffusion tensor tractography can be a new prognostic predictor for neurological recovery in CCM patients after laminoplasty.

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Prognostic value of changes in spinal cord signal intensity on magnetic resonance imaging in patients with cervical compressive myelopathy

The Spine Journal ◽

10.1016/j.spinee.2013.09.038 ◽

2014 ◽

Vol 14 (8) ◽

pp. 1601-1610 ◽

Cited By ~ 35

Author(s):

Kenzo Uchida ◽

Hideaki Nakajima ◽

Naoto Takeura ◽

Takafumi Yayama ◽

Alexander Rodriguez Guerrero ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Spinal Cord ◽

Magnetic Resonance ◽

Signal Intensity ◽

Prognostic Value ◽

Resonance Imaging ◽

Cervical Compressive Myelopathy ◽

Compressive Myelopathy

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Spinal Cord Changes After Laminoplasty in Cervical Compressive Myelopathy: A Diffusion Tensor Imaging Study

Frontiers in Neurology ◽

10.3389/fneur.2018.00696 ◽

2018 ◽

Vol 9 ◽

Cited By ~ 2

Author(s):

Young-Mi Yang ◽

Woo-Kyoung Yoo ◽

Shahid Bashir ◽

Jae-Keun Oh ◽

Yoon-Hae Kwak ◽

...

Keyword(s):

Spinal Cord ◽

Diffusion Tensor Imaging ◽

Diffusion Tensor ◽

Imaging Study ◽

Cervical Compressive Myelopathy ◽

Compressive Myelopathy ◽

Diffusion Tensor Imaging Study

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Discrimination between spinal cord injury and cervical compressive myelopathy in intramedullary high-intensity lesions on T2-weighted magnetic resonance imaging

10.21203/rs.3.rs-90889/v1 ◽

2020 ◽

Author(s):

Naosuke Kamei ◽

Kazuyoshi Nakanishi ◽

Toshio Nakamae ◽

Takayuki Tamaura ◽

Yuji Tsuchikawa ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Magnetic Resonance ◽

High Intensity ◽

Contrast Ratio ◽

Magnetic Resonance Images ◽

Signal Ratio ◽

Cord Injury ◽

Cervical Compressive Myelopathy ◽

Compressive Myelopathy

Abstract Background: When intramedullary high-intensity lesions are found on cervical T2-weighted magnetic resonance images of patients with whiplash injury, it is often required to identify whether they are due to spinal cord injury (SCI) or cervical compressive myelopathy (CCM). This is important to determine insurance coverage. Thus, this study aimed to develop a method to distinguish between SCI and CCM.Methods: Magnetic resonance images of 20 patients who had cervical SCI were evaluated. These 20 SCI patients were age- and sex-matched to 20 CCM patients. The number of discs adjacent to T2 high-intensity lesions was counted because the T2 high-intensity lesions in SCI were characterized by sagittal dilation. The “snake-eyes appearance” was assessed as a characteristic finding of CCM. T2 values in T2 high-intensity lesions were evaluated quantitatively by its ratio with the T2 values in the normal spinal cord, including signal ratio and contrast ratio.Results: The number of discs adjacent to T2 high-intensity lesions was significantly higher in SCI than in CCM. The snake-eyes appearance was found in 9 of 20 CCM patients, but not in SCI patients. The signal ratio and contrast ratio on axial images were significantly higher in SCI than in CCM. A new diagnostic scale was created based on these results. This diagnostic scale has made it possible to distinguish SCI and CCM with >90% accuracy from all perspectives including sensitivity, specificity, positive predictive value, and negative predictive value.Conclusions: The features of T2 high-intensity lesions can be used to distinguish between SCI and CCM.

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Spinal Cord Neurosarcoidosis after Cervical Compressive Myelopathy

Journal of the Korean Neurological Association ◽

10.17340/jkna.2016.3.6 ◽

2016 ◽

Vol 34 (3) ◽

pp. 205-208 ◽

Cited By ~ 1

Author(s):

Mingyeong Kim ◽

Min Su Park

Keyword(s):

Spinal Cord ◽

Cervical Compressive Myelopathy ◽

Compressive Myelopathy

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The Prevalence and Phenotype of Activated Microglia/Macrophages within the Spinal Cord of the Hyperostotic Mouse (twy/twy) Changes in Response to Chronic Progressive Spinal Cord Compression: Implications for Human Cervical Compressive Myelopathy

PLoS ONE ◽

10.1371/journal.pone.0064528 ◽

2013 ◽

Vol 8 (5) ◽

pp. e64528 ◽

Cited By ~ 31

Author(s):

Takayuki Hirai ◽

Kenzo Uchida ◽

Hideaki Nakajima ◽

Alexander Rodriguez Guerrero ◽

Naoto Takeura ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Compression ◽

Cord Compression ◽

Activated Microglia ◽

Cervical Compressive Myelopathy ◽

Compressive Myelopathy

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Postoperative changes in spinal cord signal intensity in patients with cervical compression myelopathy: comparison between preoperative and postoperative magnetic resonance images

Journal of Neurosurgery Spine ◽

10.3171/spi/2008/8/6/524 ◽

2008 ◽

Vol 8 (6) ◽

pp. 524-528 ◽

Cited By ~ 47

Author(s):

Yasutsugu Yukawa ◽

Fumihiko Kato ◽

Keigo Ito ◽

Yumiko Horie ◽

Tetsurou Hida ◽

...

Keyword(s):

Spinal Cord ◽

Magnetic Resonance ◽

Surgical Outcomes ◽

Signal Intensity ◽

Magnetic Resonance Images ◽

Mr Images ◽

Japanese Orthopedic Association ◽

Postoperative Changes ◽

Cervical Compressive Myelopathy ◽

Compressive Myelopathy

Object Increased signal intensity of the spinal cord on magnetic resonance (MR) imaging was classified pre- and postoperatively in patients with cervical compressive myelopathy. It was investigated whether postoperative classification and alterations of increased signal intensity could reflect the postoperative severity of symptoms and surgical outcomes. Methods One hundred and four patients with cervical compressive myelopathy were prospectively enrolled. All were treated using cervical expansive laminoplasty. Magnetic resonance imaging was performed in all patients preoperatively and after an average of 39.7 months postoperatively (range 12–90 months). Increased signal intensity of the spinal cord was divided into 3 grades based on sagittal T2-weighted MR images as follows: Grade 0, none; Grade 1, light (obscure); and Grade 2, intense (bright). The severity of myelopathy was evaluated according to the Japanese Orthopedic Association (JOA) score for cervical myelopathy and its recovery rate (100% = full recovery). Results Increased signal intensity was seen in 83% of cases preoperatively and in 70% postoperatively. Preoperatively, there were 18 patients with Grade 0 increased signal intensity, 49 with Grade 1, and 37 with Grade 2; postoperatively, there were 31 with Grade 0, 31 with Grade 1, and 42 with Grade 2. The respective postoperative JOA scores and recovery rates (%) were 13.9/56.7% in patients with postoperative Grade 0, 13.2/50.7% in those with Grade 1, and 12.8/40.1% in those with Grade 2, and these differences were not statistically significant. The postoperative increased signal intensity grade was improved in 16 patients, worsened in 8, and unchanged in 80 (77%). There was no significant correlation between the alterations of increased signal intensity and surgical outcomes. Conclusions The postoperative increased signal intensity classification reflected postoperative symptomatology and surgical outcomes to some extent, without statistically significant differences. The alteration of increased signal intensity was seen postoperatively in 24 patients (23%) and was not correlated with surgical outcome.

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