Magnetic Resonance Imaging association with the preoperative Neurological Status and its Predictive Value of the Postoperative Recovery in Patients with Cervical Spondylotic Myelopathy

Abstract

Introduction This is a prospective observational study of consecutive patients undergoing surgery with cervical spondylotic myelopathy (CSM), to assess the association of the quantitative assessment of preoperative magnetic resonance imaging (MRI) with the preoperative neurological status and postoperative neurological recovery. The factors of predictive value to the neurological recovery in patients with CSM postoperatively are of great interest. Currently, the significance of MRI signal changes in relation to prognosis in the literature is conflicting and inconsistent. Patients and Methods A 50 consecutive patients with CSM were studied preoperatively and postoperatively after 1 year. Modified Japanese Orthopedic Association (mJOA) was recorded preoperatively and 1 year after surgery. Using univariate and multivariate analysis, the relation of the preoperative status and postoperative recovery to quantitative MRI measurements preoperatively were assessed. Results Low T1 signal change preoperatively was associated with a lower preoperative mJOA ( p = 0.021). Focal high T2 signal was associated with lower preoperative mJOA scores ( p = 0.62). Preoperative focal T2 signal had a significant association with poorer postoperative recovery rate ( p = 0.032). Conclusion MRI signal changes can predict preoperative neurological status and postoperative recovery. The presence of hypointense T1 signal and focal hyperintense T2 signal on MRI are indicators of poorer outcome.