دورية أكاديمية
أعرض في EDS

Diffusion MRI Metrics Characterize Postoperative Clinical Outcomes After Surgery for Cervical Spondylotic Myelopathy.

التفاصيل البيبلوغرافية
العنوان: Diffusion MRI Metrics Characterize Postoperative Clinical Outcomes After Surgery for Cervical Spondylotic Myelopathy.
المؤلفون: Zhang JK; Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA.; Department of Neurological Surgery, University of Utah, Salt Lake City, Utah, USA., Javeed S; Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA., Greenberg JK; Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA., Yakdan S; Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA., Kaleem MI; Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA., Botterbush KS; Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA., Benedict B; Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA., Dibble CF; Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA., Sun P; Department of Imaging Physics, UT MD Anderson Cancer Center, Houston, Texas, USA., Sherrod B; Department of Neurological Surgery, University of Utah, Salt Lake City, Utah, USA., Dailey AT; Department of Neurological Surgery, University of Utah, Salt Lake City, Utah, USA., Bisson EF; Department of Neurological Surgery, University of Utah, Salt Lake City, Utah, USA., Mahan M; Department of Neurological Surgery, University of Utah, Salt Lake City, Utah, USA., Mazur M; Department of Neurological Surgery, University of Utah, Salt Lake City, Utah, USA., Song SK; Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA., Ray WZ; Department of Neurological Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA.
المصدر: Neurosurgery [Neurosurgery] 2024 Jun 21. Date of Electronic Publication: 2024 Jun 21.
Publication Model: Ahead of Print
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins, Inc Country of Publication: United States NLM ID: 7802914 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1524-4040 (Electronic) Linking ISSN: 0148396X NLM ISO Abbreviation: Neurosurgery Subsets: MEDLINE
أسماء مطبوعة: Publication: 2022- : [Philadelphia] : Lippincott Williams & Wilkins, Inc.
Original Publication: Baltimore, Williams & Wilkins.
مستخلص: Background and Objectives: Advanced diffusion-weighted MRI (DWI) modeling, such as diffusion tensor imaging (DTI) and diffusion basis spectrum imaging (DBSI), may help guide rehabilitation strategies after surgical decompression for cervical spondylotic myelopathy (CSM). Currently, however, postoperative DWI is difficult to interpret, owing to signal distortions from spinal instrumentation. Therefore, we examined the relationship between postoperative DTI/DBSI-extracted from the rostral C3 spinal level-and clinical outcome measures at 2-year follow-up after decompressive surgery for CSM.
Methods: Fifty patients with CSM underwent complete clinical and DWI evaluation-followed by DTI/DBSI analysis-at baseline and 2-year follow-up. Clinical outcomes included the modified Japanese Orthopedic Association score and comprehensive patient-reported outcomes. DTI metrics included apparent diffusion coefficient, fractional anisotropy, axial diffusivity, and radial diffusivity. DBSI metrics evaluated white matter tracts through fractional anisotropy, fiber fraction, axial diffusivity, and radial diffusivity as well as extra-axonal pathology through restricted and nonrestricted fraction. Cross-sectional Spearman's correlations were used to compare postoperative DTI/DBSI metrics with clinical outcomes.
Results: Twenty-seven patients with CSM, including 15, 7, and 5 with mild, moderate, and severe disease, respectively, possessed complete baseline and postoperative DWI scans. At 2-year follow-up, there were 10 significant correlations among postoperative DBSI metrics and postoperative clinical outcomes compared with 3 among postoperative DTI metrics. Of the 13 significant correlations, 7 involved the neck disability index (NDI). The strongest relationships were between DBSI axial diffusivity and NDI (r = 0.60, P < .001), DBSI fiber fraction and NDI (rs = -0.58, P < .001), and DBSI restricted fraction and NDI (rs = 0.56, P < .001). The weakest correlation was between DTI apparent diffusion coefficient and NDI (r = 0.35, P = .02).
Conclusion: Quantitative measures of spinal cord microstructure after surgery correlate with postoperative neurofunctional status, quality of life, and pain/disability at 2 years after decompressive surgery for CSM. In particular, DBSI metrics may serve as meaningful biomarkers for postoperative disease severity for patients with CSM.
(Copyright © Congress of Neurological Surgeons 2024. All rights reserved.)
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معلومات مُعتمدة: R01 - NS047592 United States NS NINDS NIH HHS; U01- EY025500 United States NS NINDS NIH HHS; TL1 - TR002344 United States TR NCATS NIH HHS
تواريخ الأحداث: Date Created: 20240621 Latest Revision: 20240621
رمز التحديث: 20240621
DOI: 10.1227/neu.0000000000003037
PMID: 38904404
قاعدة البيانات: MEDLINE
الوصف
تدمد:1524-4040
DOI:10.1227/neu.0000000000003037