Relationship between Signal Intensity Change of the Spinal Cord on MRI and Motor Myelopathic Severity in Patients with Cervical Spondylotic Myelopathy
DOI:
https://doi.org/10.3329/jninb.v1i2.29836Keywords:
Signal intensity change (SIC), motor myelopathic severity, Spinal cord, MRI, cervical spondylotic myelopathy (CSM)Abstract
Background: Diagnosis of cervical spondylotic myelopathy (CSM) can be challenging due to subtle symptoms and insidious onset; however, there is a relationship between signal intensity change of the spinal cord on MRI and cervical spondylotic myelopathy. Objective: The purpose of this present study was to find out the relationship between signal intensity change of the spinal cord on MRI and motor myelopathic severity in patients with CSM.
Methodology: This cross-sectional study was carried out in the Department of Neurosurgery at Banghabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from October, 2011 to March, 2013 for a period of one and half year. All patients presented with cervical spondylotic myelopathy were included in this study. MRI of cervical spine was performed to all patients.
Results: A total number of 36 patients with cervical spondylotic myelopathy were included in this study. Among the 36 study patients, all had normal intensity in the spinal cord on sagittal T1WI of MRI; however, there was variable intensity on sagittal T2WI of MRI. Low Nurick score was found in 24(66.6%) patients who had type 0 signal intensity on (T2WI) MRI. High Nurick score was found in 3(8.3%) patients who had type 0 signal intensity on (T2WI) MRI. Low Nurick score was found in 2(5.5%) patients who had type 1 signal intensity on (T2WI) MRI. High Nurick score was found in 6(16.6%) patients who had type 1 signal intensity on (T2WI) MRI. Only 1 patient (2.7%) having high Nurick score (3-5) had type-2 signal intensity on (T2WI) MRI (p<0.001).
Conclusion: There is a direct relationship between signal intensity change of the spinal cord on MRI and motor myelopathic severity in patients with cervical spondylotic myelopathy.
Journal of National Institute of Neurosciences Bangladesh, 2015;1(2): 37-40
Downloads
696
708
References
Colledge NR, Walker BR, Ralston SH. Neurological disease: Disorders of the spine and spinal cord. In: Colledge, N. R., Walker, B. R. & Ralston, S. H. (eds.) Davidson's Principles & Practice of Medicine. 21st ed. Edinburgh: Churchill Livingstone: Elsevier 2010;1241-1242
Wazir NN, Kareem BA. New clinical sign of cervical myelopathy: Wazir hand myelopathy sign. Singapore Med J 2011;52:47-49
Samandouras G. Cervical spondylosis. In: Samandouras G. (ed.) The Neurosurgeons Handbook. 2nd ed. New York : Oxford University Press 2010., 811-812.
http://dx.doi.org/10.1093/med/9780198570677.003.0666
Rumi MN, Yoon ST. Cervical Myelopathy: History and Physical Examination. Spine Surgery 2004;16:234-240
http://dx.doi.org/10.1053/j.semss.2004.10.004
Rhee JM, Heflin JA, Hamasaki T, Freedman B. Prevalence of physical signs in cervical myelopathy: a prospective, controlled study. Spine 2009;34(9):890-895
http://dx.doi.org/10.1097/BRS.0b013e31819c944b
Vitzthum HE, Dalitz K. Analysis of five specific scores for cervical spondylogenic myelopathy. Eur Spine J 2007;16:2096-2103
http://dx.doi.org/10.1007/s00586-007-0512-x
Emery SE. Cervical spondylotic myelopathy: diagnosis and treatment. J Am Acad Orthop Surg 2001;9(6):376-388
http://dx.doi.org/10.5435/00124635-200111000-00003
Panigrahy A, Nelson MD, Bluml S. Magnetic resonance spectroscopy in pediatric neuroradiology: clinical and research applications. Pediatr Radiol 2010;40:3-30
http://dx.doi.org/10.1007/s00247-009-1450-z
Lindsay KW, Bone I, Fuller G. Cervical Spondylosis. In: Lindsay, K. W., Bone, I. & Fuller, G. (eds.) Neurology And Neurosurgy Illustrated. 5th ed. London: Elsevier, 2010, 412-414
Vedantam A, Jonathan A, Rajshekhor V. Association of magnetic resonance imaging signal changes and outcome prediction after surgery for cervical spondylotic myelopathy. J Neurosurg Spine 2011;15:660-666.
http://dx.doi.org/10.3171/2011.8.SPINE11452
Morio Y, Teshima R, Nagashima H, Nawata K, Yamasaki D, Nanjo Y. Correlation between operative outcomes of cervical compression myelopathy and mri of the spinal cord. Spine 2001;26:1238-1245
http://dx.doi.org/10.1097/00007632-200106010-00012
Chatley A, Kumar R, Jain VK, Behari S, Sahu RN. Effect of spinal cord signal intensity changes on clinical outcome after surgery for cervical spondylotic myelopathy. J Neurosurg Spine 2009;11;562-567
http://dx.doi.org/10.3171/2009.6.SPINE091
Rota JJFD, Meschian S, Rota AFD, Urbano V, Baron M. Cervical spondylotic myelopathy due to chronic compression: the role of signal intensity changes in magnetic resonance images. J Neurosurg Spine 2007;6:17-22
Harrop JS, Naroji S, Maltenfort M, Anderson DG, Albert T, Ratliff JK, Ponnappan RK, Rihn JA, Smith HE, Hilibrand A, Sharan AD, Vaccaro A. Cervical Myelopathy: A Clinical and Radiographic Evaluation and Correlation to Cervical Spondylotic Myelopathy. Spine 2010;35(6):620-624
http://dx.doi.org/10.1097/BRS.0b013e3181b723af
Chikuda H, Seichi A, Takeshita K, Shoda N, Ono T, Matsudaira K, Kawaguchi H, Nakamura K. Correlation between pyramidal signs and the severity of cervical myelopathy. Eur Spine J 2010;19:1684-1689
Downloads
Published
How to Cite
Issue
Section
License
Copyright on any research article in the Journal of National Institute of Neurosciences Bangladesh is retained by the author(s).
The authors grant the National Institute of Neurosciences Bangladesh a license to publish the article and identify itself as the original publisher.
Articles in the Journal of National Institute of Neurosciences Bangladesh are Open Access articles published under the Creative Commons CC BY-NC License (https://creativecommons.org/licenses/by-nc/4.0/)
This license permits use, distribution and reproduction in any medium, provided the original work is properly cited, and it is not used for commercial purposes.
