Diagnostic value of cervical spine ZOOM-DWI in cervical spondylotic myelopathy.

PURPOSE: To investigate the clinical application value of the non-shared incentive diffusion imaging technique (ZOOM-DWI) diagnoses of cervical spondylotic myelopathy (CSM). METHODS: 49 CSM patients who presented from January 2022 to December 2022 were selected as the patient group, and 50 healthy volunteers are recruited as the control group. All subjects underwent conventional MRI and ZOOM-DWI of the cervical spine and neurologic mJOA scores in patients with CSM. The spinal ADC values of segments C2-3, C4-5, C5-6, and C6-7 are measured and analyzed in all subjects, with C5-6 being the most severe level of spinal canal compression in the patient group. In addition, the study also analyzes and compares the relationship between the C5-6 ADC value and mJOA score in the patient group. RESULTS: The mean ADC shows no significantly different levels in the control group. Among the ADC values at each measurement level in the patient group, except for C4-5 and C6-7 segments are not statistically significant, the remaining pair-wise comparisons all show statistically significant differences (F = 24.368, p < 0.001). And these individuals have the highest ADC value at C5-6. The C5-6 ADC value in the patient group is significantly higher compared with the ADC value in the control group (t = 9.414, p < 0.001), with statistical significance. The ADC value at the patient stenosis shows a significant negative correlation with the mJOA score (r = -0.493, p < 0.001). CONCLUSION: Cervical ZOOM-DWI can be applied to diagnose CSM, and spinal ADC value can use as reliable imaging data for diagnosing cervical myelopathy.

Predictive value of magnetic resonance imaging indications of spinal cord swelling for cervical spondylotic myelopathy prognosis.

BACKGROUND: Magnetic resonance imaging (MRI) is the preferred examination approach for patients with suspected cervical spondylotic myelopathy (CSM). OBJECTIVE: To investigate the predictive value of MRI spinal cord swelling on the prognosis of decompression surgery in patients with CSM. METHODS: A retrospective analysis of 115 patients with CSM who underwent decompression surgery was performed. According to whether cervical MRI showed spinal cord swelling, they were divided into a spinal cord swelling group and non-swelling group. The Modified Japanese Orthopaedic Association (MJOA) score, MJOA improvement rate and abnormal spinal cord enhancement rate in the two groups were compared before and after surgery. Multiple linear regression was used to analyse the influencing factors of the MJOA improvement rate. RESULTS: The time from symptom onset to operation (t= 2.400, p= 0.018) and preoperative MJOA score in the spinal cord swelling group were lower than those in the non-swelling group (t= 3.253, p= 0.002). The body mass index (t= 2.895, p= 0.005), anteroposterior diameter of the spinal canal (t= 4.421, p< 0.001), cross-sectional area (t= 3.136, p= 0.002), postoperative improvement rate (t= 4.277, p< 0.001) and proportion of abnormal enhancement of the spinal cord in the swelling group were higher than those in the non-swelling group (χ2= 3.136, p= 0.002). The preoperative MJOA score in the swelling group was lower than that in the non-swelling group (t= 2.583, p= 0.013). A multivariate linear regression model revealed that age and spinal cord swelling were independent predictors of MJOA score improvement, explaining 33.2% of the total variation. CONCLUSION: Patients with CSM with spinal cord swelling have less time from symptoms to surgery, and the degree of preoperative neurological deterioration is more obvious. Spinal cord swelling is an independent predictor of surgical prognosis in patients with CSM.