Postoperative diffusion tensor imaging parameters and their prognostic value in patients with degenerative cervical myelopathy
Objective:To analyze postoperative diffusion tensor imaging(DTI)parameters and their prognostic value in patients with degenerative cervical myelopathy(DCM).Methods:This retrospective study included 59 DCM patients(DCM group)who underwent posterior cervical longitudinal laminectomy from March 2019 to March 2020 at Beijing Jishuitan Hospital,Capital Medical University.This study was conducted from December 2020 to April 2021.The control group comprised 21 healthy volunteers recruited from December 2020 to January 2021.DTI parameters,including fractional anisotropy(FA),mean diffusivity(MD),axial diffusivity(AD),and radial diffusivity(RD),were evaluated at the C2/3 to C6/7 intervertebral discs and compared between the two groups.Cervical Japanese Orthopedic Association(JOA)scores were recorded for DCM patients to explore their correlations with DTI parameters.Results:Compared to the control group,the DCM group showed significantly increased AD,RD,and MD,and decreased FA at the most severely compressed(LMC)spinal cord segments.DCM patients with T2-weighted hyperintensity in the spinal cord had significantly higher AD,RD,and MD,and lower FA than those without.DCM patients with a reduced spinal cord cross-sectional area had significantly higher RD and MD and lower FA than those without,while there was no significant difference in AD.Cervical JOA scores were positively correlated with FA(r=0.429,P<0.001),but negatively correlated with RD and MD(r=-0.461,-0.461,both P<0.001)at LCM segments in DCM patients.Conclusions:Postoperative DTI parameters can reflect pathological changes in the spinal cord of DCM patients,with FA,MD,and RD potentially being objective indicators for spinal cord injury assessment.
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