Is the “snake-eye” MRI sign correlated to anterior spinal artery occlusion on CT angiography in cervical spondylotic myelopathy and amyotrophy?

Wang, Honggang

doi:10.1007/s00586-014-3348-1

Cited by 17 publications

(20 citation statements)

References 21 publications

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“…While the role of ischemia in the pathogenesis is controversial, small blood vessels in the spinal cord play an important role in the pathogenesis of compression and distortion. If the compression is prolonged, it may cause spinal cord degeneration, edema, cell loss, and the presence of necrosis-induced T2-hyperintense signal change known as snake eye appearance on magnetic resonance imaging (MRI) scans of the spinal cord (3,23,48). Edwards and LaRocca have reported that the sagittal diameter of the spinal cord is correlated with myelopathy.…”

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confidence: 99%

The comparison of hemilaminectomy and laminoplasty procedures in the surgical treatment of cervical spondylotic myelopathy

Karademir¹,

Küçük²,

Ulutabanca³

et al. 2015

Turkish Neurosurgery

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ABSTRACTously spreads to surrounding bone and soft tissues (11,23). The spinal canal narrows in a circular fashion due to development of a spondylotic bar in the front, uncovertebral joints in the front-side, facet joint hypertrophy, and ligamentum flavum hypertrophy on the rear-side (12,29,37,38). Degenerative altering of one or more segments of the spinal cord and nerve █ INTRODUCTION C ervical spondylosis is a progressive process that is characterized by degeneration of intervertebral discs and loss of the liquid component together with decrease of the intervertebral disc height, resulting in spinal deformation. The degeneration that starts in the intervertebral disc insidiAIm: To compare cervical hemilaminectomy with cervical laminoplasty to determine the prognostic significance of both methods in cervical spondylotic myelopathy (CSM). This study is first in the literature to compare the hemilaminectomy and laminoplasty procedures mATERIAl and mEThODS: A total of 42 patients who underwent surgery due to CSM and followed for at least 24 months were included in the study. Thirty-four out of 42 patients were males, while 8 were females; the mean age of the patients was 63.6 years (range 41-80). The visual analog scale (VAS) was used in the evaluation of postoperative axial neck pain. Factors known to affect prognosis of CSM such as patients' age, gender, duration of symptoms, pressure level, and T2-hyperintense appearance on magnetic resonance imaging (MRI) were evaluated. Patients were compared in terms of sagittal alignment of the vertebrae (instability), anterior-posterior diameter of the spinal canal, transsectional spinal canal area, axial neck pain, and recovery rate based on the preoperative and postoperative Japanase Orthopaedic Association (JOA) scores. RESUlTS:The recovery rate in patients who underwent hemilaminectomy was 60.8%±18.8, while in patients that underwent laminoplasty it was 52.8%±11.9. The comparison of both surgical techniques in terms of postoperative recovery rates did not show any significant difference between the techniques (p>0.05).CONClUSION: There were no significant differences in terms of recovery rate, preoperative and postoperative canal diameter, preoperative and postoperative spinal canal area, and postoperative sagittal alignment (p>0.05). The VAS evaluating axial neck pain was significantly lower in patients from the hemilaminectomy group compared to patients from the laminoplasty group.

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confidence: 99%

The comparison of hemilaminectomy and laminoplasty procedures in the surgical treatment of cervical spondylotic myelopathy

Karademir¹,

Küçük²,

Ulutabanca³

et al. 2015

Turkish Neurosurgery

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“…According to You et al, the type 1 pattern seems to indicate an acute, transient, and recuperative cord injury with relatively good circulation [8], making the spinal cord more vulnerable at extension because of the "pincer effect", but relatively less affected at extension. The Ax-CCM type 2 pattern, or the so called "snake-eye appearance" in MRI, however, may indicate the occlusion of anterior radiculomedullary arteries and poorer spinal cord circulation in a previous CT angiography study [33]. The vasculature of the spinal cord is organized as such that its ventral aspect and grey matter is supplied centrifugally by the central artery and the anterior part of the vasocorona, both of which arise from the anterior spinal artery.…”

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confidence: 99%

Magnetic Resonance Imaging and Dynamic X-ray's correlations with Dynamic Electrophysiological Findings in Cervical Spondylotic Myelopathy: a retrospective cohort study.

Lin

Chen

et al. 2020

Preprint

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Background Dynamic somatosensory evoked potentials (DSSEP) can be used to disclose abnormalities of ascending sensory pathways at dynamic positions and diagnose cervical spondylotic myelopathy (CSM). However, radiographic tests including magnetic resonance imaging (MRI) and dynamic X-ray are used much more widely in the management of CSM. Our study aims to clarify the correlations between several radiographic parameters and the DSSEP results, and further determine their reliability with clinical data. Methods We retrospectively enrolled 38 CSM patients with surgical intervention. DSSEP tests were performed before surgery. Amplitude ratios of DSSEP N13 and N20 waves at extension and flexion were calculated and recorded as N13_E, N20_E, N13_F, N20_F respectively. Baseline severity was evaluated with the modified Japanese Orthopedic Association (mJOA) score and the Nurick grades. Prognosis was evaluated based on the 2-year recovery rate. Sagittal diameter and transverse areas of the cord and canal were measured and the Spinal cord/Canal Area Ratio were calculated. The compressive ratios at the compressed site (Compression_Ratio), central (Central_Ratio) and 1/4-lateral points (1/4-Lateral_Compression_Ratio), and intramedullary T2 hyperintensity patterns (Ax-CCM types) were also collected from MRI axial images. Dynamic X-rays were used to test for segmental instability of the cervical spine. The correlations between radiologic findings, DSSEP data, and clinical assessments were investigated. Results We found that DSSEP N13_E and N13_F correlated with the Compression_Ratio, Central_Ratio, 1/4-Lateral_Compression_Ratio (Pearson, p < 0.05) and Ax-CCM types (ANOVA, p < 0.05) in MRI axial images and cervical segmental instability in dynamic X-ray (t-test, p < 0.05). Apart from the 1/4-Lateral_Compression_Ratio, these radiographic parameters above also correlated with the baseline clinical assessments (Spearman or ANOVA or t-test, p < 0.05) and postoperative recovery rate (Pearson or ANOVA or t-test, p < 0.05). Conclusions We found that the preoperative Compression_Ratio, Central_Ratio and 1/4-Lateral_Compression_Ratio in MRI and cervical segmental instability in dynamic X-ray could reflect the dynamic neural dysfunction of the spinal cord. Different Ax-CCM types corresponded to different DSSEP results at extension and flexion, suggesting divergent pathophysiology. These radiographic parameters could help evaluate disease severity and predict postoperative prognosis. Trial registration: The trial was retrospectively registered on April 30th, 2020 and the registration number is "[2020]151".

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“…According to You et al, the type 1 pattern seems to indicate an acute, transient, and recuperative cord injury with relatively good circulation [8], making the spinal cord more vulnerable at extension because of the "pincer effect", but relatively less affected at extension. The Ax-CCM type 2 pattern, or the so called "snake-eye appearance" in MRI, however, may indicate the occlusion of anterior radiculomedullary arteries and poorer spinal cord circulation in a previous CT angiography study [38]. The vasculature of the spinal cord is organized as such that its ventral aspect and grey matter is supplied centrifugally by the central artery and the anterior part of the vasocorona, both of which arise from the anterior spinal artery.…”

Section: Discussionmentioning

confidence: 99%

Magnetic Resonance Imaging and Dynamic X-ray's correlations with Dynamic Electrophysiological Findings in Cervical Spondylotic Myelopathy: a retrospective cohort study.

Lin

Chen

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Dynamic somatosensory evoked potentials (DSSEP) can be used to disclose abnormalities of ascending sensory pathways at dynamic positions and diagnose cervical spondylotic myelopathy (CSM). However, radiographic tests including magnetic resonance imaging (MRI) and dynamic X-ray are used much more widely in the management of CSM. Our study aims to clarify the correlations between several radiographic parameters and the DSSEP results, and further determine their reliability with clinical data.Methods: We retrospectively enrolled 38 CSM patients with surgical intervention. DSSEP tests were performed before surgery. Amplitude ratios of DSSEP N13 and N20 waves at extension and flexion were calculated and recorded as N13_E, N20_E, N13_F, N20_F, respectively. Baseline severity was evaluated with the modified Japanese Orthopedic Association (mJOA) score and the Nurick grades. Prognosis was evaluated based on the 2-year recovery rate. Sagittal diameter and transverse areas of the cord and canal were measured and the the compressive ratios at the compressed site (Compression_Ratio), central (Central_Ratio), and 1/4-lateral points (1/4-Lateral_Compression_Ratio), and spinal cord/Canal Area Ratio were calculated. The intramedullary T2 hyperintensity patterns (Ax-CCM types) were also collected from MRI axial images. Dynamic X-rays were used to test for segmental instability of the cervical spine. The correlations between radiologic findings, DSSEP data, and clinical assessments were investigated.Results: We found that DSSEP N13_E and N13_F correlated with the Compression_Ratio, Central_Ratio, 1/4-Lateral_Compression_Ratio (Pearson, p<0.05) and Ax-CCM types (ANOVA, p<0.05) in MRI axial images and cervical segmental instability in dynamic X-ray (t-test, p<0.05). Apart from the 1/4-Lateral_Compression_Ratio, these radiographic parameters above also correlated with the baseline clinical assessments (Spearman or ANOVA or t-test, p<0.05) and postoperative recovery rate (Pearson or ANOVA or t-test, p<0.05).Conclusions: We found that the preoperative Compression_Ratio, Central_Ratio and 1/4-Lateral_Compression_Ratio in MRI and cervical segmental instability in dynamic X-ray could reflect the dynamic neural dysfunction of the spinal cord. Different Ax-CCM types corresponded to different DSSEP results at extension and flexion, suggesting divergent pathophysiology. These radiographic parameters could help evaluate disease severity and predict postoperative prognosis.Trial registration: The trial "动态诱发电位对脊髓型颈椎病诊断和预后评估(Dynamic Somatosensory Evoked Potentials for the diagnostic and prognostic evaluation for Cervical Spondylotic Myelopathy)" was retrospectively registered on April 30th, 2020 and the registration number is "伦审[2020]151号".

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Is the “snake-eye” MRI sign correlated to anterior spinal artery occlusion on CT angiography in cervical spondylotic myelopathy and amyotrophy?

Abstract: ASA occlusion is not commonly seen in CSM and CSA patients with SEA. Pathological changes about SEA in CSM and CSA have no close correlation with ASA occlusion, but may be with anterior radiculomedullary arteries.

Cited by 17 publications

References 21 publications

The comparison of hemilaminectomy and laminoplasty procedures in the surgical treatment of cervical spondylotic myelopathy

The comparison of hemilaminectomy and laminoplasty procedures in the surgical treatment of cervical spondylotic myelopathy

Magnetic Resonance Imaging and Dynamic X-ray's correlations with Dynamic Electrophysiological Findings in Cervical Spondylotic Myelopathy: a retrospective cohort study.

Magnetic Resonance Imaging and Dynamic X-ray's correlations with Dynamic Electrophysiological Findings in Cervical Spondylotic Myelopathy: a retrospective cohort study.

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