Regional impairment of 18F-FDG uptake in the cervical spinal cord in patients with monosegmental chronic cervical myelopathy.

OBJECTIVE

The aim of this preliminary report was to assess glucose metabolism in the cervical spine of patients with chronic compressive myelopathy by using FDG PET.

METHODS

Ten patients with monosegmental chronic degenerative stenosis and local cord compression of the upper/middle cervical spine with signs of myelopathy on MRI and 10 control patients without known cervical abnormalities were investigated by FDG PET. Maximum standardised uptake values (SUV(max)) were measured at all levels of the cervical spine (C1-C7).

RESULTS

While the controls showed the typical pattern of homogeneous linear FDG uptake along the entire cervical cord, the patients with chronic compressive myelopathy had a normal glucose utilisation only above the level of stenosis and a significant decrease in FDG uptake below their individual level of cord compression. This may be caused by atrophy of anterior grey horn cells and the loss of glucose-consuming neurons below the level of cord compression.

CONCLUSION

FDG PET of the spine of patients with chronic compressive myelopathy may be helpful to determine the stage and severity of cervical myelopathy.