Fan Ning, Li Tusheng, Lu Xuanyu, Ma Xinyu, Yang Lihui, Du Peng, Zang Lei, Yuan Shuo
Department of Orthopedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100043, People's Republic of China.
Department of Orthopedics, Civil Aviation General Hospital, Beijing, 100123, People's Republic of China.
J Pain Res. 2025 Aug 8;18:3977-3986. doi: 10.2147/JPR.S530761. eCollection 2025.
This study aimed to examine the correlation between diffusion tensor imaging (DTI) parameters (fractional anisotropy, FA; apparent diffusion coefficient, ADC) and clinical outcomes (neck disability index, NDI; visual analog scale, VAS) in cervical spondylotic radiculopathy (CSR) patients following percutaneous cervical nucleoplasty (PCN), respectively.
This is a cross-sectional study. We collected clinical data from 30 patients with CSR who underwent DTI before and 3 months after PCN. The FA and ADC were derived from DTI. The NDI and VAS were used to evaluate the clinical symptoms preoperatively, at 3 months postoperatively, and at the final follow-up. By setting multiple region of interest areas, the cervical nerve roots were delineated using fiber tractography. The Pearson correlation analysis was used to investigate the relationship between DTI values and clinical severity.
NDI and VAS scores after PCN were significantly improved compared with preoperative scores (P < 0.05). The FA and ADC values after PCN were significantly different from the preoperative values (P < 0.001). The Pearson correlation revealed that preoperative FA values were strongly correlated with preoperative NDI scores (r = -0.802, P < 0.001), whereas postoperative FA values were strongly correlated with postoperative NDI scores (r = -0.804, P < 0.001). Furthermore, postoperative FA values were strongly correlated with NDI scores at the final follow-up (r = -0.805, P < 0.001). However, no significant difference was observed between the DTI and VAS scores. Similarly, no significant correlations were observed between ADC values and NDI scores pre- and postoperatively.
DTI is an imaging method that helps identify the clinical functional status of patients with CSR after PCN. The FA value can be used as a potential predictor of patient prognosis and are strongly negatively correlated with NDI scores. However, the long-term predictive effect warrants further investigation.
本研究旨在分别探讨经皮颈椎间盘髓核成形术（PCN）后神经根型颈椎病（CSR）患者的扩散张量成像（DTI）参数（分数各向异性，FA；表观扩散系数，ADC）与临床结局（颈部功能障碍指数，NDI；视觉模拟评分，VAS）之间的相关性。
这是一项横断面研究。我们收集了30例CSR患者在PCN术前及术后3个月进行DTI检查的临床资料。FA和ADC值来自DTI。NDI和VAS用于评估术前、术后3个月及末次随访时的临床症状。通过设置多个感兴趣区域，利用纤维束成像勾勒出颈神经根。采用Pearson相关分析研究DTI值与临床严重程度之间的关系。
与术前相比，PCN术后NDI和VAS评分显著改善（P < 0.05）。PCN术后FA和ADC值与术前值有显著差异（P < 0.001）。Pearson相关分析显示，术前FA值与术前NDI评分密切相关（r = -0.802，P < 0.001），而术后FA值与术后NDI评分密切相关（r = -0.804，P < 0.001）。此外，术后FA值与末次随访时的NDI评分密切相关（r = -0.805，P < 0.001）。然而，DTI与VAS评分之间未观察到显著差异。同样，术前和术后ADC值与NDI评分之间也未观察到显著相关性。
DTI是一种有助于识别PCN术后CSR患者临床功能状态的成像方法。FA值可作为患者预后的潜在预测指标，且与NDI评分呈强负相关。然而，其长期预测效果有待进一步研究。
