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The relevance of intramedullary high signal intensity and gadolinium (Gd-DTPA) enhancement to the clinical outcome in cervical compressive myelopathy

 Yong Eun Cho  ;  Jun Jae Shin  ;  Woo Ho Cho  ;  Ji Hae Lee  ;  Sung Uk Kuh  ;  Dong Kyu Chin  ;  Keun Su Kim 
 European Spine Journal, Vol.20(12) : 2267-2274, 2011 
Journal Title
 European Spine Journal 
Issue Date
PURPOSE: We prospectively investigated whether high intramedullary SI and contrast [gadolinium-diethylene-triamine-pentaacetic acid (Gd-DTPA)] enhancement in magnetic resonance imaging (MRI) are associated with postoperative prognosis in cervical compressive myelopathy (CCM) patients. METHODS: Seventy-four patients with ventral cord compression at one or two levels underwent anterior cervical discectomy and fusion (ACDF) for CCM between March 2006 and June 2009. The mean follow-up period was 39.7 months (range, 12.7-55.7 months). The cervical cord compression ratio and clinical outcomes were measured using Japanese Orthopedic Association (JOA) scores for cervical myelopathy. Patients were classified into three groups based on the SI change in T2WI, T1-weighted images (T1WI), and contrast (Gd-DTPA) enhancement. RESULTS: The mean preoperative and postoperative JOA scores were 10.5 ± 2.9 and 15.0 ± 2.1 (P < 0.05), respectively. The mean recovery ratio of the JOA score was 70.9 ± 20.2%. There were statistically significant differences in postoperative JOA and recovery ratio among three groups. However, post-surgical neurological outcomes were not associated with age, symptom duration, preoperative JOA, and cord compression. CONCLUSIONS: We found that intramedullary SI change is a poor prognostic factor and the intramedullary contrast (Gd-DTPA) enhancement on preoperative MRI should be viewed as the worst predictor of surgical outcomes in cervical myelopathy. Contrast (Gd-DTPA) enhancement and postoperative MRI are useful for identifying the prognosis of patients with poor neurological recovery.
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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실)
Yonsei Authors
구성욱(Kuh, Sung Uk) ; 김근수(Kim, Keun Su) ; 조용은(Cho, Yong Eun) ; 진동규(Chin, Dong Kyu)
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