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Clinical application of diffusion tensor tractography to postoperative C5 palsy
Morito Takano1,2, Osahiko Tsuji3, Kanehiro Fujiyoshi1,4
1Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan.
Spinal Cord Series and Cases
|September 23, 2021
Summary
Diffusion tensor tractography (DTT) can detail C5 palsy after cervical laminoplasty by showing reduced tract fibers at the affected spinal cord levels. This imaging technique may help understand the pathophysiology of this complication.
Area of Science:
- Neurosurgery
- Radiology
- Spinal Cord Imaging
Background:
- C5 palsy is a known complication following cervical procedures, but its exact cause is unclear.
- Diffusion tensor tractography (DTT) offers a non-invasive method to quantitatively assess spinal cord pathology.
Purpose of the Study:
- To evaluate the clinical utility of DTT in diagnosing C5 palsy after cervical laminoplasty.
Main Methods:
- A diagnostic study involving five patients with C5 palsy post-cervical laminoplasty.
- Diffusion tensor tractography (DTT) was performed using 1.5 Tesla MRI.
- Regions of interest (ROI) were placed at the C5 spinal cord level and C4/5 intervertebral foramen levels.
Main Results:
- Postoperative DTT showed increased tract fibers at the C5 segmental level, yet decreased fibers on the affected side compared to the intact side.
- In a patient with spontaneous recovery, DTT revealed gradual augmentation of tract fibers on the palsy side.
- DTT identified reduced tract fibers between the C5 segmental level and C4/5 intervertebral foramen on the affected side.
Conclusions:
- DTT can effectively document C5 palsy, highlighting potential damage in the C5 segmental to C4/5 intervertebral foramen region.
- Findings suggest DTT is a valuable tool for understanding the pathophysiology of C5 palsy after laminoplasty.
