The Assessment of Neuronal Status in Normal and Cervical Spondylotic Myelopathy Using Diffusion Tensor Imaging

Abstract

3.

The Contribution of Diffusion Tensor Imaging to Quantitative Assessment on Multilevel Cervical Spondylotic Myelopathy

“…Not only a positive correlation between FA at MCL and mJOA score in agreement with previous studies [14,16,18, 26] did we find, but also it is one of the few studies that showed a significant correlation between clinical severity and the mean FA values at total and lesion levels. Indeed, a majority of former studies measured DTI only at MCL and never took other non-compression levels into consideration.…”

“…With the exception of the change at MCL like previous studies [16][17][18] , we found, patients with MCSM had a significant difference in various mean values compared with those in the control group. Probably it will produce increased water mobility and permit water molecules to diffuse toward 73 more directions than in intact axons, where primary diffusion is along a single direction as soon as axons are injured, which must contribute to increased ADC and a loss of anisotropy with decreased FA [16] . So far, no clear conclusion has yet been reached on whether the MCL can be defined as the pathogenic level.…”

“…To the best of our knowledge, several studies have investigated the distinction between CSM patients and control regarding DTI measurements and the correlation between DTI parameters and clinical severity [16][17][18] . However, a majority of the above-mentioned studies simply measured at the maximal compression level (MCL) to prove the presence of white matter injury.…”

Association of Preoperative Cervical Spine Alignment With Spinal Cord Magnetic Resonance Imaging Hyperintensity and Myelopathy Severity

“…Indeed, abnormalities on spinal neuroimaging will continue to provide surrogates of disease activity, with newer modalities potentially gaining higher sensitivity. These include tractography [16][17][18][19] and spectroscopy. 20 The reciprocal relationships of SVA eff ect in patients with kyphosis and those with lordosis may refl ect an optimal spinal alignment to achieve during surgical management.…”

Cervical spondylotic myelopathy: what the neurologist should know

“…They found that smoking increased the production and release of inflammatory cytokines, determining decomposition of chondrocyte activity and as a result, disc degeneration. 16 Other factors related to CSM are the presence of Down syndrome, repeated occupational trauma, genetic predisposition and Klippel-Feil syndrome. 17-20 Noteworthy is also the presence of calcification of the posterior longitudinal ligament, complete or incomplete, present in 2% of Japanese and 25% of patients with CSM and due to mutations of inorganic pirofasfatase, which controls calcium metabolism from soft tissues.…”