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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Correlation Analysis of Surgical Efficacy and Risk Factors of Cervical Spondylotic Myelopathy with High Signal Intensity on MRI-T2WI

Author(s): Ziang Xu, Liang Xiao, Chen Liu, Quanlai Zhao, Yu Zhang and Hongguang Xu*

Volume 19, Issue 2, 2023

Published on: 28 March, 2022

Article ID: e110122200143 Pages: 7

DOI: 10.2174/1573405618666220111121650

Price: $65

Abstract

Objectives: The purpose of this study was to investigate the surgical efficacy and risk factors of cervical spondylotic myelopathy (CSM) patients with increased signal intensity (ISI) on T2-weighted magnetic resonance imaging (MRI-T2WI).

Methods: We compared the surgical outcomes of CSM patients with and without ISI. In addition, we compared the efficacy of anterior and posterior cervical decompression in CSM patients with ISI. We also analyzed the risk factors of MRI-T2WI ISI in CSM patients.

Results: The incidence of ISI among 153 CSM patients was 71.89 %. The JOA score and JOA remission rate were better in the ISI-free than in the ISI group. The postoperative JOA score and JOA remission rate were better in the posterior than the anterior approach surgery group. The disease duration and vertebral canal volume were found to be risk factors for ISI in CSM patients.

Conclusion: Among patients with CSM, the prognosis is worse for those with ISI than those without ISI. Posterior cervical decompression surgery produces a better curative effect than anterior cervical decompression surgery in CSM patients with ISI. CSM patients with longer disease duration and small vertebral canal volume should undergo surgical treatment as early as possible.

Keywords: Increased signal intensity, cervical spondylotic myelopathy, clinical efficacy, surgical approach, risk factors, vertebral canal.

Graphical Abstract

[1]
Tracy JA, Bartleson JD. Cervical spondylotic myelopathy. Neurologist 2010; 16(3): 176-87.
[http://dx.doi.org/10.1097/NRL.0b013e3181da3a29] [PMID: 20445427]
[2]
Lau D, Winkler EA, Than KD, Chou D, Mummaneni PV. Laminoplasty versus laminectomy with posterior spinal fusion for multilevel cervical spondylotic myelopathy: Influence of cervical alignment on outcomes. J Neurosurg Spine 2017; 27(5): 508-17.
[http://dx.doi.org/10.3171/2017.4.SPINE16831] [PMID: 28862572]
[3]
Liu X, Min S, Zhang H, Zhou Z, Wang H, Jin A. Anterior corpectomy versus posterior laminoplasty for multilevel cervical myelopathy: A systematic review and meta-analysis. Eur Spine J 2014; 23(2): 362-72.
[http://dx.doi.org/10.1007/s00586-013-3043-7] [PMID: 24097230]
[4]
Song KJ, Lee KB, Song JH. Efficacy of multilevel anterior cervical discectomy and fusion versus corpectomy and fusion for multilevel cervical spondylotic myelopathy: A minimum 5-year follow-up study. Eur Spine J 2012; 21(8): 1551-7.
[http://dx.doi.org/10.1007/s00586-012-2296-x] [PMID: 22526699]
[5]
Chikhale CB, Khurjekar KS, Shyam AK, Sancheti PK. Correlation between preoperative magnetic resonance imaging signal intensity changes and clinical outcomes in patients surgically treated for cervical myeloradiculopathy. Asian Spine J 2017; 11(2): 174-80.
[http://dx.doi.org/10.4184/asj.2017.11.2.174] [PMID: 28443160]
[6]
Takahashi M, Yamashita Y, Sakamoto Y, Kojima R. Chronic cervical cord compression: Clinical significance of increased signal intensity on MR images. Radiology 1989; 173(1): 219-24.
[http://dx.doi.org/10.1148/radiology.173.1.2781011] [PMID: 2781011]
[7]
Bommireddy R, Kamat A, Smith ET, Nixon T, Pillay R, Pigott T. Magnetic resonance image findings in the early post-operative period after anterior cervical discectomy. Eur Spine J 2007; 16(1): 27-31.
[http://dx.doi.org/10.1007/s00586-005-0045-0] [PMID: 16421746]
[8]
Herzog RJ. Point of view: Post-operative resolution of MRI signal intensity changes and the associated impact on outcomes in degenerative cervical myelopathy - Analysis of a global cohort of patients. Spine 2018; 43(12): 832.
[http://dx.doi.org/10.1097/BRS.0000000000002445] [PMID: 29846364]
[9]
Resnick DK. Magnetic resonance imaging signal change patterns and prognosis for myelopathy. Spine J 2010; 10(6): 510-1.
[http://dx.doi.org/10.1016/j.spinee.2010.04.004] [PMID: 20494812]
[10]
Uchida K, Nakajima H, Takeura N, et al. Prognostic value of changes in spinal cord signal intensity on magnetic resonance imaging in patients with cervical compressive myelopathy. Spine J 2014; 14(8): 1601-10.
[http://dx.doi.org/10.1016/j.spinee.2013.09.038] [PMID: 24411833]
[11]
Urrutia J, Besa P, Campos M, Cikutovic P, Cabezon M, Molina M. The Pfirrmann classification of lumbar intervertebral disc degeneration: An independent inter- and intra-observer agreement assessment. Eur Spine J 2016; 25(9): 2728-33.
[http://dx.doi.org/10.1007/s00586-016-4438-z] [PMID: 26879918]
[12]
Horne PH, Lampe LP, Nguyen JT, Herzog RJ, Albert TJ. A novel radiographic indicator of developmental cervical stenosis. J Bone Joint Surg Am 2016; 98(14): 1206-14.
[http://dx.doi.org/10.2106/JBJS.15.01231] [PMID: 27440569]
[13]
Miyazaki M, Notani N, Ishihara T, Kanezaki S, Tsumura H. Surgical outcomes after laminoplasty for cervical spondylotic myelopathy: A focus on the dynamic factors and signal intensity changes in the intramedullary spinal cord on MRI. Clin Neurol Neurosurg 2017; 162: 108-14.
[http://dx.doi.org/10.1016/j.clineuro.2017.10.003] [PMID: 29017106]
[14]
Machino M, Yukawa Y, Ito K, et al. Can magnetic resonance imaging reflect the prognosis in patients of cervical spinal cord injury without radiographic abnormality? Spine 2011; 36(24): E1568-72.
[http://dx.doi.org/10.1097/BRS.0b013e31821273c0] [PMID: 21289591]
[15]
Yukawa Y, Kato F, Yoshihara H, Yanase M, Ito K. MR T2 image classification in cervical compression myelopathy: Predictor of surgical outcomes. Spine 2007; 32(15): 1675-8.
[http://dx.doi.org/10.1097/BRS.0b013e318074d62e] [PMID: 17621217]
[16]
Wada E, Ohmura M, Yonenobu K. Intramedullary changes of the spinal cord in cervical spondylotic myelopathy. Spine 1995; 20(20): 2226-32.
[http://dx.doi.org/10.1097/00007632-199510001-00009] [PMID: 8545717]
[17]
Alafifi T, Kern R, Fehlings M. Clinical and MRI predictors of outcome after surgical intervention for cervical spondylotic myelopathy. J Neuroimaging 2007; 17(4): 315-22.
[http://dx.doi.org/10.1111/j.1552-6569.2007.00119.x] [PMID: 17894620]
[18]
Fernández de Rota JJ, Meschian S, Fernández de Rota A, Urbano V, Baron M. Cervical spondylotic myelopathy due to chronic compression: The role of signal intensity changes in magnetic resonance images. J Neurosurg Spine 2007; 6(1): 17-22.
[http://dx.doi.org/10.3171/spi.2007.6.1.4] [PMID: 17233286]
[19]
Mastronardi L, Elsawaf A, Roperto R, et al. Prognostic relevance of the postoperative evolution of intramedullary spinal cord changes in signal intensity on magnetic resonance imaging after anterior decompression for cervical spondylotic myelopathy. J Neurosurg Spine 2007; 7(6): 615-22.
[http://dx.doi.org/10.3171/SPI-07/12/615] [PMID: 18074686]
[20]
Yukawa Y, Kato F, Ito K, et al. Postoperative changes in spinal cord signal intensity in patients with cervical compression myelopathy: comparison between preoperative and postoperative magnetic resonance images. J Neurosurg Spine 2008; 8(6): 524-8.
[http://dx.doi.org/10.3171/SPI/2008/8/6/524] [PMID: 18518672]
[21]
Chatley A, Kumar R, Jain VK, Behari S, Sahu RN. Effect of spinal cord signal intensity changes on clinical outcome after surgery for cervical spondylotic myelopathy. J Neurosurg Spine 2009; 11(5): 562-7.
[http://dx.doi.org/10.3171/2009.6.SPINE091] [PMID: 19929358]
[22]
Avadhani A, Rajasekaran S, Shetty AP. Comparison of prognostic value of different MRI classifications of signal intensity change in cervical spondylotic myelopathy. Spine J 2010; 10(6): 475-85.
[http://dx.doi.org/10.1016/j.spinee.2010.03.024] [PMID: 20494809]
[23]
Li F, Chen Z, Zhang F, Shen H, Hou T. A meta-analysis showing that high signal intensity on T2-weighted MRI is associated with poor prognosis for patients with cervical spondylotic myelopathy. J Clin Neurosci 2011; 18(12): 1592-5.
[http://dx.doi.org/10.1016/j.jocn.2011.04.019] [PMID: 22018808]
[24]
Seng C, Tow BP, Siddiqui MA, et al. Surgically treated cervical myelopathy: a functional outcome comparison study between multilevel anterior cervical decompression fusion with instrumentation and posterior laminoplasty. Spine J 2013; 13(7): 723-31.
[http://dx.doi.org/10.1016/j.spinee.2013.02.038] [PMID: 23541452]
[25]
Luo J, Cao K, Huang S, et al. Comparison of anterior approach versus posterior approach for the treatment of multilevel cervical spondylotic myelopathy. Eur Spine J 2015; 24(8): 1621-30.
[http://dx.doi.org/10.1007/s00586-015-3911-4] [PMID: 25840781]
[26]
Yagi M, Ninomiya K, Kihara M, Horiuchi Y. Long-term surgical outcome and risk factors in patients with cervical myelopathy and a change in signal intensity of intramedullary spinal cord on magnetic resonance imaging. J Neurosurg Spine 2010; 12(1): 59-65.
[http://dx.doi.org/10.3171/2009.5.SPINE08940] [PMID: 20043766]
[27]
Zhang JT, Wang LF, Wang S, Li J, Shen Y. Risk factors for poor outcome of surgery for cervical spondylotic myelopathy. Spinal Cord 2016; 54(12): 1127-31.
[http://dx.doi.org/10.1038/sc.2016.64] [PMID: 27137121]

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