Spinal Cord Changes After Laminoplasty in Cervical Compressive Myelopathy: A Diffusion Tensor Imaging Study.

Area of Science:

• Neuroscience
• Radiology
• Orthopedic Surgery

Background:

• Cervical myelopathy (CM) necessitates surgical intervention for spinal cord integrity.
• Longitudinal studies using diffusion tensor imaging (DTI) to assess pathological changes in CM patients post-surgery are lacking.

Purpose of the Study:

• To longitudinally evaluate diffusion metrics at and below the lesion level in CM patients following laminoplasty using DTI.
• To correlate diffusion metrics with functional recovery as measured by the modified Japanese Orthopedic Association (mJOA) score.

Main Methods:

• Twenty CM patients and 20 age-matched healthy controls were analyzed.
• DTI metrics (FA, MD, AD, RD) were measured in six regions of interest (anterior, posterior, lateral) at preoperative and 6-month postoperative stages.
• Comparison of diffusion metrics and mJOA scores between preoperative and postoperative states, and with controls.

Main Results:

• Significant postoperative changes in anterior diffusion metrics were observed at and below the lesion level.
• Postoperative axial diffusivity (AD) decreased in lateral and posterior regions, approaching control levels.
• Fractional anisotropy (FA) in anterior regions post-surgery positively correlated with mJOA scores below the lesion.

Conclusions:

• This is the first study to demonstrate longitudinal changes in spinal cord diffusion metrics at and below the lesion site after laminoplasty in CM patients.
• Observed DTI changes suggest potential associations with functional recovery and spinal cord integrity restoration post-surgery.