The Severity of Myelopathy as a Diagnostic and Prognostic Indicator in the Treatment of Patients with Cervical Spinal Stenosis

Abstract

Cervical spinal stenosis is accompanied by dysfunction of the spinal cord, leading to numerous complications and disability of patients. These issues are well known to radiologists, vertebrologists, and neurosurgeons, however, not all of multiple diagnostic problems and issues of surgical treatment can be considered resolved.Purpose of the study. Justification of the possibilities and necessity of qualitative and quantitative MRI study of the severity of myelopathy in cervical spinal stenosis.Materials and methods. The results of an MRI examination of 82 patients with cervical spinal stenosis due to degenerative processes were carried out with the use of osteoplastic bilateral laminoplasty technique with simultaneous foraminotomy under neurophysiological control. The examination was conducted before and after the treatment. The study was carried out using standard programs, such as T2 haste localizer, t2_tse_cor_p2, t2_tse_sag_p2, t1_tse_sag_p2.Results. The focus of myelopathy was detected by MRI in 74.4 % of cases, which confirmed the severity of the pathology. 28 out of 60 patients with myelopathy displayed a clearly defined «snakeeyes» sign, also knows as «owl-eyes» or «fried-eggs» appearance. In some patients, one zone was identified in the form of a rounded focus of increased signal intensity on the axial section.The average value of the signal intensity coefficient in patients before treatment was 1.89 ± 0.31, after treatment — 1.63 ± 0.21. Significant differences in MRI before and after treatment occurred in 45 % of patients.Conclusion. The results of the work showed that quantitative assessment of the signal intensity from the spinal cord in stenosis can be used to assess the severity of myelopathy and compare data before and after treatment. In order to identify the source of the most intense signal more accurately and increase the overall measurement accuracy, it is advisable to carry out color mapping of images.