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MRI Results Predict Surgical Outcome for Cervical Myelopathy

MRIs are often used to see what's going on inside the spine. Neck pain and other symptoms from pressure on the spinal cord shows up well on an MRI. This condition is called cervical myelopathy.

Studies show that signal changes occur on MRI for patients with cervical myelopathy who have significant stenosis. Stenosis is a narrowing of the spinal canal, the opening where the spinal cord is located.

But the question is: are there other factors that are just as important as the MRI in making the decision to have surgery? Are there other factors that are more important such as age or duration of symptoms? Can we just rely on the MRI results?

In this study, researchers look to see if the signal intensity on MRIs was linked with severity of symptoms and the results of surgery for cervical myelopathy. Severity of myelopathy and improvement in symptoms were analyzed and compared to results of MRIs taken before surgery. Other factors included in the analysis were age and duration of disease. Function before and after surgery and recovery rate were also measured.

Increased MRI signal intensity (SI) is often seen in cases of myelopathy. Of the 104 patients tested, 83 per cent had increased SI. This group was older and had their symptoms longer than the other patients. They also had poor results after surgery and a slow recovery rate.

In the future, the timing of surgery for myelopathy may be based just on MRI results. Surgery for stenosis had the best results when done early before the patients developed neurologic symptoms and disability.

References: Yasutsugu Yukawa, MD, et al. MR T2 Image Classification in Cervical Compression Myelopathy. In Spine. July 1, 2007. Vol. 32. No. 15. Pp. 1675-1678.

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