Increased Signal Intensity of the Spinal Cord on Magnetic Resonance Images in Cervical Compressive Myelopathy

Matsumoto, Morio; Toyama, Yoshiaki; Ishikawa, Masayuki; Chiba, Kazuhiro; Suzuki, Noriomi; Fujimura, Yoshikazu

doi:10.1097/00007632-200003150-00005

Cited by 180 publications

(93 citation statements)

References 15 publications

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“…Prospective studies in which patients were randomized into conservative and operative treatment groups have suggested that patients with mild CSM do not frequently progress at early time points (2-3 years) [27,28,32].…”

Section: Conservative Managementmentioning

confidence: 99%

Cervical Spondylotic Myelopathy: Pathophysiology, Clinical Presentation, and Treatment

Lebl¹,

Hughes²,

Cammisa³

et al. 2011

HSS Jrnl

132

111

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Section: Conservative Managementmentioning

confidence: 99%

Cervical Spondylotic Myelopathy: Pathophysiology, Clinical Presentation, and Treatment

Lebl¹,

Hughes²,

Cammisa³

et al. 2011

HSS Jrnl

132

111

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“…The most serious complication is spinal cord compression, resulting in neural tissue damage and a syndrome of spinal cord dysfunction known as cervical spondylotic myelopathy (CSM). Magnetic resonance imaging (MRI) is the modality of choice for quantifying the extent of degenerative alterations and spinal canal narrowing, though it has been proven to have low sensitivity in myelopathy detection, ranging 15-65 % [1][2][3][4][5][6]. Abnormal T2 signal intensity of the compressed spinal cord, which is considered to reflect myelopathic changes, is not always present, even in very advanced stages of clinically evident myelopathy, and poorly correlates with disease severity [7,8].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of diffusion tensor MR imaging in the assessment of intramedullary changes of the cervical spinal cord in different stages of degenerative spine disease

et al. 2014

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Purpose The aim of this study was to evaluate the usefulness of diffusion tensor imaging (DTI) in the detection of cervical spinal cord integrity alterations in different stages of degenerative spine disease, as well as to compare DTI parameters with selected cervical spinal stenosis measurements. Methods One hundred and thirty-two symptomatic patients (mean age 53.58 years) with different stages of cervical spondylosis and twenty-five control subjects (mean age 45.78 years) were enrolled in the study. DTI was performed with a 1.5 T MR scanner. Three hundred and forty-nine spine segments from C2/C3 to C5/C6 were evaluated and divided into five groups according to the degree of spinal cord compression. The values of fractional anisotropy (FA) and apparent diffusion coefficient at each level were calculated and their correlations with the degree of stenosis were analyzed.Results FA values differed significantly (p \ 0.0001) at all levels between the control group and patients with cervical degenerative disease, including subjects without spinal cord compression visible on plain MR images. A significant (p \ 0.01) positive correlation between the mean FA values and anteroposterior diameter of the spinal canal as well as space available for the spinal cord index was demonstrated at all investigated levels. Conclusion DTI is capable of revealing impairment of the cervical spinal cord microstructure at the very early stage of degenerative spine disease, even prior to spinal cord compression visible on plain MR. Anteroposterior spinal canal diameter as well as space available for the cord index is well related to spinal cord tissue integrity defined by DTI.

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“…Yapılan son çalışmalarda, servikal miyelopatinin tedavisinde, sebep ister servikal disk hernisi, ister spondiloza bağlı kanal darlığı olsun, kompresyon miyelopatisi hafif düzeyde ise, öncelikle prognostik faktörlerin belirlenmesi ve hastaların konservatif tedavi ile takip edilmesinin tedavinin daha uygun olduğu savunulmaktadır (11)(12)(13). Bizim vakamızda da servikal MRG'de miyelomalazik sinyal değişikliği olmasına rağmen belirgin nörolojik defisitin olmayışı acilen cerrahiye yönlenmeden önce prognostik faktörlerin değerlendirilmesi gerektiği sonucuna varmamıza neden olmuştur.…”

Section: Discussionunclassified

Subklinik Servikal Miyelopatiye Yaklaşım: Olgu Sunumu

...

2012

Tftr

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ÖzetSık görülmesine ve en az 50 yıldır bilinmesine rağmen, servikal miyelopatinin doğal seyri, patogenezi, semptom ve bulguların düzelmesinde konservatif ve cerrahi tedavilerin etkinliği halen tartışmalıdır. Özellikle klinikte ara sıra karşımıza çıkan, radyolojik olarak miyelomalazik sinyal değişikliği olup, belirgin semptom veya bulgu saptamadığımız ve literatürde "subklinik" ya da "pre-semptomatik" olarak adlandırılan hasta grubunda tedavi ile ilgili çelişkili veriler yer almaktadır. Manyetik rezonans görüntülemede spinal korddaki sinyal değişikliği klinisyenleri hızla miyelopati tanısını koymaya yönlendirse de, son yıllarda yapılan araştırmalar optimal tedavi seçiminin ve prognoz tayininin sadece görüntüleme ile yapılamayacağını göstermektedir. Hastaya özel tedavi şeklinin belirlenmesinde, semptomların süresi, detaylı ve belli aralıklarla yapılan nörolojik değerlendirmeler, elektrofizyolojik bulgular, Japon Ortopedi Derneği Miyelopati skoru gibi bir takım klinik skorlama yöntemlerinin de son derece önemli olduğu vurgulanmış ve bu verilerin tümünün birlikte değerlendirilmesi durumunda tedavi için doğru karar verilebileceği üzerinde durulmuştur. Bu bilgilerin ışığında; kliniğimizde tanı koyup izlenmekte olan, radyolojik olarak miyelopati bulgusu olup; ancak klinikte belirgin nörolojik bulgu saptanmayan bir olgunun sunulması ve bu tip hastalara yaklaşımın literatür eşliğinde tartışılması amaçlanmıştır. Türk Fiz T›p Re hab Derg 2012;58:335-9. Anah tar Ke li me ler: Miyelopati; servikal miyelopati; subklinik miyelopati; miyelomalazi Sum maryCervical myelopathy is a spinal cord lesion caused by cervical stenosis compressing the spinal cord and vascular structures. Despite the common occurrence and large amount of information has been published about cervical myelopathy for at least 50 years, the effectiveness of the conservative and surgical treatments on the natural history, pathogenesis and especially the prognosis of the disease is still controversial. As a result of this controversy, in everyday clinical practice many doctors are still hesitant to commit themselves to a treatment regimen and are unable to predict the natural course of the disease. Although cervical cord compression is prerequisite for the clinical diagnosis and detected easily by myelomalacic signal changes on MRI, previous studies have demonstrated the existence of asymptomatic spinal cord compression detected by MRI. Little is known about the spontaneous course and prognosis of clinically "silent" or "subclinical" cervical cord myelomalasia. In addition, conflicting data on the prognosis and the treatment of this subclinical patient group exist in the literature. In order to determine the prognosis and patient-specific treatment modality; duration of symptoms, detailed neurological assessment made at regular intervals, electrophysiological findings, clinical myelopathy scoring methods such as the Japanese Orthopaedic Association Score as well as myelomalacic changes should be taken into consideration and decisionmaking must then be based on t...

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Increased Signal Intensity of the Spinal Cord on Magnetic Resonance Images in Cervical Compressive Myelopathy

Abstract: Increased signal intensity was not related to a poor outcome of conservative treatment or severity of myelopathy in the patients with mild cervical myelopathy.

Cited by 180 publications

References 15 publications

Cervical Spondylotic Myelopathy: Pathophysiology, Clinical Presentation, and Treatment

Cervical Spondylotic Myelopathy: Pathophysiology, Clinical Presentation, and Treatment

Usefulness of diffusion tensor MR imaging in the assessment of intramedullary changes of the cervical spinal cord in different stages of degenerative spine disease

Subklinik Servikal Miyelopatiye Yaklaşım: Olgu Sunumu

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