Department of Orthopedics, the People's Hospital of China Three Gorges University, the First People's Hospital of Yichang, Hubei, China.
Spine (Phila Pa 1976). 2020 Aug 15;45(16):E999-E1005. doi: 10.1097/BRS.0000000000003480.
A prospective study.
To investigate the association between microstructural changes measured by diffusion tensor imaging (DTI) and clinical symptoms and their duration in patients with cervical spondylotic myelopathy (CSM) affected by single level.
No report was reported regarding the association between the microstructural changes and the symptoms and their duration at single-level spinal cord compression.
Twenty-nine consecutive patients with CSM and 29 normal subjects were enrolled in this study. DTI with tractography was performed on the cervical spinal cord. Clinical symptoms were evaluated using modified Japanese Orthopaedic Association (mJOA) scores for each patient, and the duration of clinical symptoms was noted based on the earliest instance of limb pain or numbness or weakness or bladder dysfunction. Mean fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were calculated from tractography images.
The mean FA value of the cervical compressed spinal cord was significantly lower than the FA of the normal population (P < 0.001). The mean ADC value in the cervical compressed spinal cord was obviously higher than those of normal cervical spinal cord (P < 0.001). In the CSM patients, a significant positive association was observed between FA values and mJOA scores (P < 0.001). However, there were a notable negative association between mJOA scores and ADC values (P < 0.001), and between mJOA scores and symptom duration (P < 0.001).
These results illustrate DTI can measure the micostructural changes of cervical spinal cord and DTI parameters are potential biomarkers for spinal cord dysfunction in patients with CSM.
前瞻性研究。
探讨颈椎脊髓病（CSM）单节段受压患者弥散张量成像（DTI）测量的微观结构变化与临床症状及其持续时间的关系。
尚无报道表明单节段脊髓压迫时微观结构变化与症状及其持续时间之间存在相关性。
本研究纳入 29 例 CSM 患者和 29 例正常对照者。对颈椎脊髓进行 DTI 及轨迹成像。采用改良日本矫形协会（mJOA）评分对每位患者的临床症状进行评估，并根据肢体疼痛、麻木、无力或膀胱功能障碍的最早出现时间记录临床症状持续时间。从轨迹图像中计算平均各向异性分数（FA）和表观扩散系数（ADC）值。
颈椎受压脊髓的平均 FA 值明显低于正常人群（P<0.001）。颈椎受压脊髓的平均 ADC 值明显高于正常颈椎脊髓（P<0.001）。在 CSM 患者中，FA 值与 mJOA 评分之间存在显著正相关（P<0.001）。然而，mJOA 评分与 ADC 值之间（P<0.001）以及 mJOA 评分与症状持续时间之间（P<0.001）呈明显负相关。
这些结果表明 DTI 可测量颈椎脊髓的微观结构变化，DTI 参数可能是 CSM 患者脊髓功能障碍的潜在生物标志物。
3。
