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

Frontiers in Neurology, 2018 · DOI: 10.3389/fneur.2018.00696 · Published: August 29, 2018

Spinal Cord Injury Neuroimaging Neurology

Simple Explanation

Cervical myelopathy (CM) is a condition that affects the spinal cord in the neck, leading to symptoms like unsteady gait and clumsy hands. This study uses a special type of MRI called diffusion tensor imaging (DTI) to look at changes in the spinal cord of CM patients after they have surgery called laminoplasty. DTI measures how water molecules move in the spinal cord, providing information about the health of the white matter. The study compares DTI measurements before and after surgery to see if laminoplasty helps to improve the condition of the spinal cord. The results showed that laminoplasty can lead to changes in the spinal cord both at the site of the problem and below it, and these changes may be related to improvements in how well patients can function.

Study Duration

September 2010 and August 2012

Participants

20 CM patients and 20 age-matched healthy controls

Evidence Level

Not specified

Key Findings

1
CM patients showed significant changes in their postoperative diffusion metrics for the anterior ROIs compared with the preoperative measures both at and below the lesion level.
2
In the lateral and posterior cord, the preoperative AD value decreased after laminoplasty to the control at the lesion level.
3
The postoperative anterior FA value was positively correlated with the postoperative mJOA score below the lesion level.

Research Summary

This study investigates the changes in the spinal cord after laminoplasty in patients with cervical myelopathy (CM) using diffusion tensor imaging (DTI). The results indicate that laminoplasty leads to significant changes in diffusion metrics at and below the lesion level, particularly in the anterior regions of the spinal cord. These changes are associated with functional recovery, as evidenced by the correlation between postoperative anterior FA values and mJOA scores below the lesion level.

Practical Implications

Surgical Efficacy Validation

The study validates the efficacy of decompression surgery (laminoplasty) in patients with CM by demonstrating improvements in spinal cord integrity.

Prognostic Tool

DTI metrics can be used to predict functional recovery after laminoplasty in CM patients, particularly by assessing changes in the anterior spinal cord below the lesion level.

Targeted Rehabilitation Strategies

The findings suggest that rehabilitation strategies should focus on improving function in the anterior regions of the spinal cord to maximize recovery after laminoplasty.

Study Limitations

1
Technical problems arising from severe compression might have made it difficult to distinguish the ROIs at the lesion level.
2
Surgical factor, which would have increased the local extracellular edema in specific areas.
3
The significant diffusion metrics changes we observed in the lateral and posterior ROIs at and below the lesion level could not be correlated with sensory symptoms since the mJOA score does not represents the specific sensory function.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury