Cervical Spondylotic Myelopathy: Can MR Spectroscopy Be Helpful?

Abstract

AbstractBackground: Spinal cord myelopathy can happen due to cord compression in variable situations. Understanding bio-chemical and metabolic changes in myelopathy are needed to expect treatment outcomes. The non-invasive technique of 1H-MRS can provide data about chemical microenvironment related to tissue metabolic changes by measuring of N-acetyl-aspartate (NAA), choline (Cho), and creatine (Cr) [1-8].Aim of Study: The aim of current study is to evaluate the diagnostic value of 1H-MRS in the assessment of biochemical changes in cervical spondylotic myelopathy.Subjects and Methods: 26 subjects with cervical myelop-athy and 12 volunteers who were age-matched with no neu-rological problems were considered as control group. MR spectroscopy was done and analysis of MRS to detect NAA (2.0ppm), Cho (3.25ppm), Cr (3.03ppm) and Lactate (Lac) (1.32ppm). Recording of NAA/Cr as well as Cho/Cr were done.Results: Detection of peak of lactate was possible in 10 patients; however no lactate peak was noted in the members of control group.The NAA/Cr ratio was recorded and comparison was done between patient and control group and showed significant difference as the mean NAA/Cr in control subjects equaled 1.87±0.05 versus 1.33±0.057 for patient group (p<0.0001) Figs. (2-6).Furthermore mean NAA/Cr ratio in subjects with lactate peak was lower than that in patients without such peak (1.268±0.028 versus 1.365±0.034) with significant difference (p<0.0001).There was no significant difference between the mean Cho/Cr ratio in patient group and control group (mean= 0.783±0.065 versus 0.764±0.049, p=0.38).Also the mean ratio of Cho/Cr of lactate peak patients was not significantly different from those without lactate (0.79±0.074 versus 0.77±0.061, p=0.44).Conclusion: MRS can provide good data about the meta-bolic changes in patients with Cervical Spondylotic Myelop-athy (CSM).