Predictors of surgical outcome in cervical spondylotic myelopathy: focusing on the quantitative signal intensity

Zhang, Jing Tao; Meng, Fan Tao; Wang, Shuai; Wang, Lin Feng; Shen, Yong

doi:10.1007/s00586-015-4109-5

Cited by 30 publications

(12 citation statements)

References 29 publications

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“…MRI-derived T2 and T1 signal change in the spinal cord tissue had been the main focus of such work, starting with the qualitative detection of an intra-axial signal change to the more recent attempts at quantification of signal intensity, or signal change ratios. While some correlation exists from a qualitative standpoint for T1 24 and T2, 25 the quantitative results in both regards are inconsistent. [26][27][28] Some studies did show correlation with baseline functional status, but not with outcomes.…”

Section: Discussionmentioning

confidence: 95%

Diffusion Tensor Imaging in a Large Longitudinal Series of Patients With Cervical Spondylotic Myelopathy Correlated With Long-Term Functional Outcome

et al. 2018

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Section: Discussionmentioning

confidence: 95%

Diffusion Tensor Imaging in a Large Longitudinal Series of Patients With Cervical Spondylotic Myelopathy Correlated With Long-Term Functional Outcome

et al. 2018

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“…Darüber hinaus wurden negative Effekte einer hohen "Signal Ratio" in den präoperativen T2-Sequenzen bei zervikaler Myelopathie nachgewiesen. Bei Werten über 1,46 stellten sich schlechtere klinische Ergebnisse ein [62].…”

Section: Radiologische Outcome-relevante Faktorenunclassified

“…Zhang et al [62] Patienten mit zervikaler Myelopathie und hoher präoperativer "Signal Ratio" in präoperativen T2-Sequenzen des MRTs gehen mit geringerem postoperativem funktionellem Verbesserungspotenzial einher.…”

Section: Signal Change Ratiounclassified

Outcome-relevante Faktoren in der Wirbelsäulenchirurgie

Spiegl¹,

Josten²,

Heyde³

2020

Die Wirbelsäule

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Several parameters might influence the outcome after vertebral spine surgeries. In order to find these a systematic literature search was performed. Thereby, a total of 62 articles were selected. All outcome-relevant parameters were categorized into patient-specific, course-specific, and radiologic parameters. Furthermore, scores were included which help to estimate the risk of adverse events and outcome for certain pathologies and/or surgeries. Patient-specific parameters were predominantly the patient age and several specific secondary diagnoses such as diabetes, adipositas, depression, anxiety disorders, and nicotine abuse. Additionally, the patient expectation plays an important role in the subjective outcome assessment. Course-specific parameters are mainly perioperative factors such as surgical experience, particularly in highly demanding vertebral spine surgeries. Furthermore, modern intraoperative equipment such as intraoperative CT and neuromonitoring helps to increase patient safety. The most outcome-relevant radiologic parameters are those which define the sagittal balance. Thereby, a correct sagittal balance is associated with superior clinical outcomes.

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“…If the T2WI signal changes are regressing after surgery, better postoperative outcomes should be expected (Class II evidence) [95]. Higher preoperative signal change ratio correlates with worse clinical outcome [96].…”

Section: Diagnostic Tests For Csmmentioning

confidence: 99%

Cervical Spondylotic Myelopathy: Natural Course and the Value of Diagnostic Techniques –WFNS Spine Committee Recommendations

et al. 2019

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ObjectiveThis study presents the results of a systematic literature review conducted to determine most up-to-date information on the natural outcome of cervical spondylotic myelopathy (CSM) and the most reliable diagnostic techniques. MethodsA literature search was performed for articles published during the last 10 years. ResultsThe natural course of patients with cervical stenosis and signs of myelopathy is quite variable. In patients with no symptoms, but significant stenosis, the risk of developing myelopathy with cervical stenosis is approximately 3% per year. Myelopathic signs are useful for the clinical diagnosis of CSM. However, they are not highly sensitive and may be absent in approximately one-fifth of patients with myelopathy. The electrophysiological tests to be used in CSM patients are motor evoked potential (MEP), spinal cord evoked potential, somatosensory evoked potential, and electromyography (EMG). The differential diagnosis of CSM from other neurological conditions can be accomplished by those tests. MEP and EMG monitoring are useful to reduce C5 root palsy during CSM surgery. Notable spinal cord T2 hyperintensity on cervical magnetic resonance imaging (MRI) is correlated with a worse outcome, whereas lighter signal changes may predict better outcomes. T1 hypointensity should be considered a sign of more advanced disease. ConclusionThe natural course of CSM is quite variable. Signal changes on MRI and some electrophysiological tests are valuable adjuncts to diagnosis.

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Predictors of surgical outcome in cervical spondylotic myelopathy: focusing on the quantitative signal intensity

Abstract: Preoperative SCR significantly reflected the surgical outcome in patients with CSM. Patients with SCR greater than or equal to 1.46 can experience poor recovery after surgery.

Cited by 30 publications

References 29 publications

Diffusion Tensor Imaging in a Large Longitudinal Series of Patients With Cervical Spondylotic Myelopathy Correlated With Long-Term Functional Outcome

Diffusion Tensor Imaging in a Large Longitudinal Series of Patients With Cervical Spondylotic Myelopathy Correlated With Long-Term Functional Outcome

Outcome-relevante Faktoren in der Wirbelsäulenchirurgie

Cervical Spondylotic Myelopathy: Natural Course and the Value of Diagnostic Techniques –WFNS Spine Committee Recommendations

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