A meta-analysis showing that high signal intensity on T2-weighted MRI is associated with poor prognosis for patients with cervical spondylotic myelopathy.

We used PubMed, Medline, and EMBASE to conduct a meta-analysis to determine the significance of high signal intensity on T2-weighted MRI for predicting postoperative prognosis in patients with cervical spondylotic myelopathy (CSM). Although patients with CSM with high signal intensity on T2-weighted MRI usually had a poor prognosis even after undergoing surgery, some researchers have argued recently that high-intensity signals are not associated with postoperative prognosis. Data consistent with the inclusion criteria of this study were cited for meta-analysis using Review Manager 5 Software. The postoperative recovery ratio specified by the Japanese Orthopedic Association (JOA) was assessed using the weighted mean difference (WMD) method. Five articles (one prospective; four retrospective) involving 309 patients with CSM were included. The aggregate WMD with regard to the postoperative JOA recovery ratio between the T2-weighted high signal intensity positive (+) group and the T2-weighted high signal intensity negative (-) group was -6.56, and the 95% confidence interval (CI) was -12.15 to -0.97 (p=0.02). Thus, we concluded that in patients with CSM, the postoperative JOA recovery ratio in the T2-weighted (+) group was lower than that in the T2-weighted (-) group.