The relevance of intramedullary high signal intensity and gadolinium (Gd-DTPA) enhancement to the clinical outcome in cervical compressive myelopathy
Purpose We prospectively investigated whether high intramedullary SI and contrast [gadolinium-diethylene-triamine-pentaacetic acid (Gd-DTPA)] enhancement in magnetic resonance imaging (MRI) are associated with postoperative prognosis in cervical compressive myelopathy (CCM) patients. Methods Seventy...
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| Veröffentlicht in: | European spine journal 2011-12, Vol.20 (12), p.2267-2274 |
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| creator | Cho, Yong Eun Shin, Jun Jae Kim, Keun Su Chin, Dong Kyu Kuh, Sung Uk Lee, Ji Hae Cho, Woo Ho |
| description | Purpose
We prospectively investigated whether high intramedullary SI and contrast [gadolinium-diethylene-triamine-pentaacetic acid (Gd-DTPA)] enhancement in magnetic resonance imaging (MRI) are associated with postoperative prognosis in cervical compressive myelopathy (CCM) patients.
Methods
Seventy-four patients with ventral cord compression at one or two levels underwent anterior cervical discectomy and fusion (ACDF) for CCM between March 2006 and June 2009. The mean follow-up period was 39.7 months (range, 12.7–55.7 months). The cervical cord compression ratio and clinical outcomes were measured using Japanese Orthopedic Association (JOA) scores for cervical myelopathy. Patients were classified into three groups based on the SI change in T2WI, T1-weighted images (T1WI), and contrast (Gd-DTPA) enhancement.
Results
The mean preoperative and postoperative JOA scores were 10.5 ± 2.9 and 15.0 ± 2.1 (
P
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| doi_str_mv | 10.1007/s00586-011-1878-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3229731</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2525623421</sourcerecordid><originalsourceid>FETCH-LOGICAL-c566t-7767b98341e9941cea7af5c69ee29ef902b7094c0082598b1106a687ca8b6123</originalsourceid><addsrcrecordid>eNqFkstu1DAUhi0EotPCA7BBFhvKIuDLxJdNpapAQaoEi9lbjuckcZXYg52MNA_C--J0SrlIiJWlc77zH_9HP0IvKHlLCZHvMiG1EhWhtKJKqoo_Qiu65qwimrPHaEX0mlRCUn2CTnO-JYTWmoin6IRRKbWq9Qp93_SAEwywt8EBji32YUp2hO08DDYdcO-7HmffBTssLQjZTwdswxZ3dhsHH_w84vPrbfV-8_XyDYbQL0IjhAlPEU9F3S2QK-NxnlwcochgB2l_VyuFXYKc_R7weIAh7uzUH56hJ60dMjy_f8_Q5uOHzdWn6ubL9eery5vK1UJMlZRCNlrxNQWt19SBlbatndAATEOrCWtkuYEjRLFaq4ZSIqxQ0lnVCMr4Gbo4yu7mpjh2sFgfzC75sVg30XrzZyf43nRxbzhjWnJaBF7fC6T4bYY8mdFnB-VyAeKcjWZCqZrcrfoPSZRcM81VIV_9Rd7GOZXzL5CsFadUFIgeIZdizgnah09TYpZsmGM2TMmGWbJheJl5-bvbh4mfYSgAOwK5tEIH6dfmf6v-AJBNxwU</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>907583116</pqid></control><display><type>article</type><title>The relevance of intramedullary high signal intensity and gadolinium (Gd-DTPA) enhancement to the clinical outcome in cervical compressive myelopathy</title><source>MEDLINE</source><source>SpringerNature Journals</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Cho, Yong Eun ; Shin, Jun Jae ; Kim, Keun Su ; Chin, Dong Kyu ; Kuh, Sung Uk ; Lee, Ji Hae ; Cho, Woo Ho</creator><creatorcontrib>Cho, Yong Eun ; Shin, Jun Jae ; Kim, Keun Su ; Chin, Dong Kyu ; Kuh, Sung Uk ; Lee, Ji Hae ; Cho, Woo Ho</creatorcontrib><description>Purpose
We prospectively investigated whether high intramedullary SI and contrast [gadolinium-diethylene-triamine-pentaacetic acid (Gd-DTPA)] enhancement in magnetic resonance imaging (MRI) are associated with postoperative prognosis in cervical compressive myelopathy (CCM) patients.
Methods
Seventy-four patients with ventral cord compression at one or two levels underwent anterior cervical discectomy and fusion (ACDF) for CCM between March 2006 and June 2009. The mean follow-up period was 39.7 months (range, 12.7–55.7 months). The cervical cord compression ratio and clinical outcomes were measured using Japanese Orthopedic Association (JOA) scores for cervical myelopathy. Patients were classified into three groups based on the SI change in T2WI, T1-weighted images (T1WI), and contrast (Gd-DTPA) enhancement.
Results
The mean preoperative and postoperative JOA scores were 10.5 ± 2.9 and 15.0 ± 2.1 (
P
< 0.05), respectively. The mean recovery ratio of the JOA score was 70.9 ± 20.2%. There were statistically significant differences in postoperative JOA and recovery ratio among three groups. However, post-surgical neurological outcomes were not associated with age, symptom duration, preoperative JOA, and cord compression.
Conclusions
We found that intramedullary SI change is a poor prognostic factor and the intramedullary contrast (Gd-DTPA) enhancement on preoperative MRI should be viewed as the worst predictor of surgical outcomes in cervical myelopathy. Contrast (Gd-DTPA) enhancement and postoperative MRI are useful for identifying the prognosis of patients with poor neurological recovery.</description><identifier>ISSN: 0940-6719</identifier><identifier>EISSN: 1432-0932</identifier><identifier>DOI: 10.1007/s00586-011-1878-3</identifier><identifier>PMID: 21779859</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer-Verlag</publisher><subject>Adult ; Age ; Aged ; Central nervous system diseases ; Cervical Vertebrae - pathology ; Cervical Vertebrae - surgery ; Clinical outcomes ; Compression ; Decompression, Surgical - methods ; Diskectomy - methods ; Follow-Up Studies ; Gadolinium ; Gadolinium DTPA ; Humans ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neurosurgery ; Original ; Original Article ; Orthopedics ; Postoperative Period ; Prognosis ; Prospective Studies ; Spinal cord ; Spinal Cord Compression - pathology ; Spinal Cord Compression - surgery ; Spinal Fusion - methods ; Spine ; Statistical analysis ; Surgical Orthopedics ; Treatment Outcome</subject><ispartof>European spine journal, 2011-12, Vol.20 (12), p.2267-2274</ispartof><rights>Springer-Verlag 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c566t-7767b98341e9941cea7af5c69ee29ef902b7094c0082598b1106a687ca8b6123</citedby><cites>FETCH-LOGICAL-c566t-7767b98341e9941cea7af5c69ee29ef902b7094c0082598b1106a687ca8b6123</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229731/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3229731/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,41488,42557,51319,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21779859$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cho, Yong Eun</creatorcontrib><creatorcontrib>Shin, Jun Jae</creatorcontrib><creatorcontrib>Kim, Keun Su</creatorcontrib><creatorcontrib>Chin, Dong Kyu</creatorcontrib><creatorcontrib>Kuh, Sung Uk</creatorcontrib><creatorcontrib>Lee, Ji Hae</creatorcontrib><creatorcontrib>Cho, Woo Ho</creatorcontrib><title>The relevance of intramedullary high signal intensity and gadolinium (Gd-DTPA) enhancement to the clinical outcome in cervical compressive myelopathy</title><title>European spine journal</title><addtitle>Eur Spine J</addtitle><addtitle>Eur Spine J</addtitle><description>Purpose
We prospectively investigated whether high intramedullary SI and contrast [gadolinium-diethylene-triamine-pentaacetic acid (Gd-DTPA)] enhancement in magnetic resonance imaging (MRI) are associated with postoperative prognosis in cervical compressive myelopathy (CCM) patients.
Methods
Seventy-four patients with ventral cord compression at one or two levels underwent anterior cervical discectomy and fusion (ACDF) for CCM between March 2006 and June 2009. The mean follow-up period was 39.7 months (range, 12.7–55.7 months). The cervical cord compression ratio and clinical outcomes were measured using Japanese Orthopedic Association (JOA) scores for cervical myelopathy. Patients were classified into three groups based on the SI change in T2WI, T1-weighted images (T1WI), and contrast (Gd-DTPA) enhancement.
Results
The mean preoperative and postoperative JOA scores were 10.5 ± 2.9 and 15.0 ± 2.1 (
P
< 0.05), respectively. The mean recovery ratio of the JOA score was 70.9 ± 20.2%. There were statistically significant differences in postoperative JOA and recovery ratio among three groups. However, post-surgical neurological outcomes were not associated with age, symptom duration, preoperative JOA, and cord compression.
Conclusions
We found that intramedullary SI change is a poor prognostic factor and the intramedullary contrast (Gd-DTPA) enhancement on preoperative MRI should be viewed as the worst predictor of surgical outcomes in cervical myelopathy. Contrast (Gd-DTPA) enhancement and postoperative MRI are useful for identifying the prognosis of patients with poor neurological recovery.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Central nervous system diseases</subject><subject>Cervical Vertebrae - pathology</subject><subject>Cervical Vertebrae - surgery</subject><subject>Clinical outcomes</subject><subject>Compression</subject><subject>Decompression, Surgical - methods</subject><subject>Diskectomy - methods</subject><subject>Follow-Up Studies</subject><subject>Gadolinium</subject><subject>Gadolinium DTPA</subject><subject>Humans</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neurosurgery</subject><subject>Original</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Postoperative Period</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Spinal cord</subject><subject>Spinal Cord Compression - pathology</subject><subject>Spinal Cord Compression - surgery</subject><subject>Spinal Fusion - methods</subject><subject>Spine</subject><subject>Statistical analysis</subject><subject>Surgical Orthopedics</subject><subject>Treatment Outcome</subject><issn>0940-6719</issn><issn>1432-0932</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNqFkstu1DAUhi0EotPCA7BBFhvKIuDLxJdNpapAQaoEi9lbjuckcZXYg52MNA_C--J0SrlIiJWlc77zH_9HP0IvKHlLCZHvMiG1EhWhtKJKqoo_Qiu65qwimrPHaEX0mlRCUn2CTnO-JYTWmoin6IRRKbWq9Qp93_SAEwywt8EBji32YUp2hO08DDYdcO-7HmffBTssLQjZTwdswxZ3dhsHH_w84vPrbfV-8_XyDYbQL0IjhAlPEU9F3S2QK-NxnlwcochgB2l_VyuFXYKc_R7weIAh7uzUH56hJ60dMjy_f8_Q5uOHzdWn6ubL9eery5vK1UJMlZRCNlrxNQWt19SBlbatndAATEOrCWtkuYEjRLFaq4ZSIqxQ0lnVCMr4Gbo4yu7mpjh2sFgfzC75sVg30XrzZyf43nRxbzhjWnJaBF7fC6T4bYY8mdFnB-VyAeKcjWZCqZrcrfoPSZRcM81VIV_9Rd7GOZXzL5CsFadUFIgeIZdizgnah09TYpZsmGM2TMmGWbJheJl5-bvbh4mfYSgAOwK5tEIH6dfmf6v-AJBNxwU</recordid><startdate>20111201</startdate><enddate>20111201</enddate><creator>Cho, Yong Eun</creator><creator>Shin, Jun Jae</creator><creator>Kim, Keun Su</creator><creator>Chin, Dong Kyu</creator><creator>Kuh, Sung Uk</creator><creator>Lee, Ji Hae</creator><creator>Cho, Woo Ho</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20111201</creationdate><title>The relevance of intramedullary high signal intensity and gadolinium (Gd-DTPA) enhancement to the clinical outcome in cervical compressive myelopathy</title><author>Cho, Yong Eun ; Shin, Jun Jae ; Kim, Keun Su ; Chin, Dong Kyu ; Kuh, Sung Uk ; Lee, Ji Hae ; Cho, Woo Ho</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c566t-7767b98341e9941cea7af5c69ee29ef902b7094c0082598b1106a687ca8b6123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Central nervous system diseases</topic><topic>Cervical Vertebrae - pathology</topic><topic>Cervical Vertebrae - surgery</topic><topic>Clinical outcomes</topic><topic>Compression</topic><topic>Decompression, Surgical - methods</topic><topic>Diskectomy - methods</topic><topic>Follow-Up Studies</topic><topic>Gadolinium</topic><topic>Gadolinium DTPA</topic><topic>Humans</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neurosurgery</topic><topic>Original</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Postoperative Period</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Spinal cord</topic><topic>Spinal Cord Compression - pathology</topic><topic>Spinal Cord Compression - surgery</topic><topic>Spinal Fusion - methods</topic><topic>Spine</topic><topic>Statistical analysis</topic><topic>Surgical Orthopedics</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cho, Yong Eun</creatorcontrib><creatorcontrib>Shin, Jun Jae</creatorcontrib><creatorcontrib>Kim, Keun Su</creatorcontrib><creatorcontrib>Chin, Dong Kyu</creatorcontrib><creatorcontrib>Kuh, Sung Uk</creatorcontrib><creatorcontrib>Lee, Ji Hae</creatorcontrib><creatorcontrib>Cho, Woo Ho</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European spine journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cho, Yong Eun</au><au>Shin, Jun Jae</au><au>Kim, Keun Su</au><au>Chin, Dong Kyu</au><au>Kuh, Sung Uk</au><au>Lee, Ji Hae</au><au>Cho, Woo Ho</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The relevance of intramedullary high signal intensity and gadolinium (Gd-DTPA) enhancement to the clinical outcome in cervical compressive myelopathy</atitle><jtitle>European spine journal</jtitle><stitle>Eur Spine J</stitle><addtitle>Eur Spine J</addtitle><date>2011-12-01</date><risdate>2011</risdate><volume>20</volume><issue>12</issue><spage>2267</spage><epage>2274</epage><pages>2267-2274</pages><issn>0940-6719</issn><eissn>1432-0932</eissn><abstract>Purpose
We prospectively investigated whether high intramedullary SI and contrast [gadolinium-diethylene-triamine-pentaacetic acid (Gd-DTPA)] enhancement in magnetic resonance imaging (MRI) are associated with postoperative prognosis in cervical compressive myelopathy (CCM) patients.
Methods
Seventy-four patients with ventral cord compression at one or two levels underwent anterior cervical discectomy and fusion (ACDF) for CCM between March 2006 and June 2009. The mean follow-up period was 39.7 months (range, 12.7–55.7 months). The cervical cord compression ratio and clinical outcomes were measured using Japanese Orthopedic Association (JOA) scores for cervical myelopathy. Patients were classified into three groups based on the SI change in T2WI, T1-weighted images (T1WI), and contrast (Gd-DTPA) enhancement.
Results
The mean preoperative and postoperative JOA scores were 10.5 ± 2.9 and 15.0 ± 2.1 (
P
< 0.05), respectively. The mean recovery ratio of the JOA score was 70.9 ± 20.2%. There were statistically significant differences in postoperative JOA and recovery ratio among three groups. However, post-surgical neurological outcomes were not associated with age, symptom duration, preoperative JOA, and cord compression.
Conclusions
We found that intramedullary SI change is a poor prognostic factor and the intramedullary contrast (Gd-DTPA) enhancement on preoperative MRI should be viewed as the worst predictor of surgical outcomes in cervical myelopathy. Contrast (Gd-DTPA) enhancement and postoperative MRI are useful for identifying the prognosis of patients with poor neurological recovery.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer-Verlag</pub><pmid>21779859</pmid><doi>10.1007/s00586-011-1878-3</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | European spine journal, 2011-12, Vol.20 (12), p.2267-2274 |
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| source | MEDLINE; SpringerNature Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adult Age Aged Central nervous system diseases Cervical Vertebrae - pathology Cervical Vertebrae - surgery Clinical outcomes Compression Decompression, Surgical - methods Diskectomy - methods Follow-Up Studies Gadolinium Gadolinium DTPA Humans Magnetic resonance imaging Magnetic Resonance Imaging - methods Male Medicine Medicine & Public Health Middle Aged Neurosurgery Original Original Article Orthopedics Postoperative Period Prognosis Prospective Studies Spinal cord Spinal Cord Compression - pathology Spinal Cord Compression - surgery Spinal Fusion - methods Spine Statistical analysis Surgical Orthopedics Treatment Outcome |
| title | The relevance of intramedullary high signal intensity and gadolinium (Gd-DTPA) enhancement to the clinical outcome in cervical compressive myelopathy |
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