Correlation of diffusion tensor imaging parameters with neural status in Pott's spine

Area of Science:

• Neuroimaging
• Spinal Cord Injury
• Tuberculosis

Background:

• Diffusion tensor imaging (DTI) is established for assessing cervical trauma and spondylotic myelopathy, correlating with neurological deficits and recovery.
• Its utility in Pott's spine (spinal tuberculosis) with paraplegia remains unexplored.
• This study investigates the correlation between DTI parameters and neurological deficits in Pott's spine patients.

Purpose of the Study:

• To evaluate the correlation of DTI parameters (Fractional Anisotropy, Mean Diffusivity) with neurological deficit in patients with Pott's spine and paraplegia.
• To assess changes in DTI parameters after treatment.
• To determine if Tractography is consistent with paraplegia severity.

Main Methods:

• Prospective study of 34 spinal TB patients undergoing DTI before and after 6 months of treatment.
• Assessed Fractional Anisotropy (FA), Mean Diffusivity (MD), and Tractography.
• Neurological deficit graded using Jain and Sinha scoring.

Main Results:

• No significant pre-treatment decrease in mean FA at the lesion site compared to controls.
• A significant decrease in mean FA at the lesion site was observed post-treatment (p=0.02).
• Moderate positive correlation (r=0.49) found between post-treatment FA and neurological score; Tractography was inconsistent with paraplegia severity.

Conclusions:

• Epidural collection and inflammation in Pott's spine complicate accurate DTI assessment of cord compression.
• DTI parameters, particularly FA, show potential for monitoring treatment response in Pott's spine, despite limitations.
• Findings contrast with DTI's established role in cervical trauma and spondylotic myelopathy.