Correlation between magnetic resonance T2-weighted increased signal intensity position and prognosis of cervical spondylotic myelopathy

Abstract

To investigate the correlation between position of the spinal cord with increased signal intensity (ISI) on magnetic resonance images (MRI) and the outcome of surgical treatment for cervical spondylotic myelopathy (CSM). Seventy-two patients with CSM who underwent preoperative MRI were selected. Pre- and post-operative clinical status was evaluated by modified Japanese Orthopedic Association (JOA) score. ISI was evaluated according to the T2-weighted sequences. The JOA score and the recovery ratios among patients with ISI in gray matter (group A), in both gray and white matter (group B) and ISI-negative group were compared. Forty patients were in ISI-negative group. ISI presenting only in gray matter included 21 cases (group A) and 11 cases were in both gray and white matter group (group B). Preoperative JOA score of ISI positive and negative group had significant difference, but the recovery ratios had no significant difference [recovery ratios of two groups at week 1, week 14, and week 52 were (20.8 +/- 14.5)%, (51.1 +/- 15.6)%, (60.1 +/- 14.2)% and (20.3 +/- 14.3)%, (54.4 +/- 22.3)% and (61.2 +/- 22.3)% respectively; P > 0.05]. The recovery ratios of negative group and group A in week 104 were superior to group B [recovery ratios of negative group, group A, and group B in week 52 were (61.2 +/- 22.3)%, (64.3 +/- 13.3)% and (50.1 +/- 11.2)% respectively; P < 0.05]. Patients with ISI in the gray matter alone on T2-weighted MR images have no significantly different surgical outcomes as compared with those without ISI. Patients with ISI in both gray and white matter have worse surgical outcomes than those without ISI.