Magnetization Transfer Ratio and Morphometrics Of the Spinal Cord Associates with Surgical Recovery in Patients with Degenerative Cervical Myelopathy. World neurosurgery Paliwal, M. n., Weber, K. A., Hopkins, B. S., Cantrell, D. R., Hoggarth, M. A., Elliott, J. M., Dahdaleh, N. S., Mackey, S. n., Parrish, T. D., Dhaher, Y. n., Smith, Z. A. 2020

Abstract

Longitudinal Cohort Study OBJECTIVES: To assess prognostic value of pre-surgical Magnetization Transfer Ratio (MTR) and morphometrics of the spinal cord in patients with Degenerative Cervical Myelopathy (DCM).Thirteen subjects with DCM underwent 3T magnetization transfer imaging. MTR was calculated for spinal cord regions and specific white matter tracts. Morphometric measures were extracted. Clinical (modified Japanese orthopedics Association (mJOA) and Nurick) and health related quality of life scores were assessed before and after cervical decompression surgery. Association between MRI metrics and post- surgical recovery was assessed (Spearman's correlation). Receiver operator characteristics (ROC) assessed the accuracy of MRI metrics in identifying at least 50% recovery in function.Preoperative anterior cord MTR were associated with recovery in mJOA scores (? =0.608, p=0.036 and AUC =0.66). Preoperative lateral cord MTR was correlated with neck disability index (? =0.699, p=0.011) and pain interference (? =0.732, p=0.007). Preoperative rubrospinal tract MTR was associated mJOA score recovery (? =0.573, p=0.041, AUC= 0.86). Preoperative corticospinal tract and reticulospinal MTR were related to recovery in pain interference scores (? =0.591, p=0.033 and ? =0.583, p=0.035). Eccentricity of the cord was associated with Nurick scores (? = 0.606, p=0.028) and mJOA (? =0.651, p=0.025, AUC=0.92).Preoperative MTR and eccentricity measurements of the spinal cord have prognostic value in assessing response to surgery and recovery in patient with DCM. Advanced MRI and atlas-based post processing techniques can inform interventions and advance healthcare received by patients with DCM.

View details for DOI 10.1016/j.wneu.2020.09.148

View details for PubMedID 33010502