Utility of Diffusion Tensor Imaging in Predicting Outcomes Following Surgical Treatment of Degenerative Cervical Myelopathy.

BACKGROUND

The utility of diffusion tensor imaging (DTI) in predicting surgical outcomes in degenerative cervical myelopathy (DTI) remains controversial.

OBJECTIVE

To identify the preoperative clinical and radiological factors associated with poor outcomes following surgical treatment of DCM.

METHODS AND MATERIAL: This prospective cohort study included patients who underwent surgery for DCM. MRI parameters (compression ratio, CR; transverse area, TA; signal-intensity ratio, SIR) and DTI parameters (fractional anisotropy, FA; apparent diffusion coefficient, ADC; relative anisotropy, RA; volume ratio, VR) were assessed preoperatively. Demographic and operative data were collected. Based on the improvement in modified Japanese Orthopaedic Association (mJOA) score at 4 months, patients were categorized as group A (good surgical outcome) and group B (poor surgical outcome). Univariate and regression analyses were performed to identify risk factors and predictors, respectively, of poor surgical outcome.

RESULTS

Sixty-six patients were included. Thirty-eight patients belonged to group A (good outcome) and 28 patients belonged to group B (poor outcome). There was no significant difference between the two groups in demographic and operative variables. FA was found to be significantly less in group B compared to group A (550 vs. 610, P = 0.04). No significant difference was seen in RA, CR, TA, SIR, ADC, and VR between the two groups. On regression analysis, no independent predictor of poor outcome could be identified.

CONCLUSIONS

Preoperative FA was found to be significantly lower in patients with poor outcome following surgical treatment for DCM.