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Degenerative cervical spondylotic myelopathy (DCM) is characterized by chronic osteoarthritic changes that lead to stenosis of the cervical spinal canal, which can lead to progressive neurological dysfunction and physical disability
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Compensatory reorganization of sensory and motor cortices has been shown to play an important role in limiting neurological deterioration in patients with DCM
Degenerative cervical spondylotic myelopathy (DCM) is characterized by chronic osteoarthritic changes that lead to stenosis of the cervical spinal canal, which can lead to progressive neurological dysfunction and physical disability
Whether progressive loss of axonal conduction along sensorimotor tracts after surgery in patients with degenerative cervical myelopathy (DCM) can be recovered and whether subsequent adaptive microstructural changes are associated with improved neurological function remains unknown
The University of California investigated upstream restoration of microstructural integrity and reorganization of microstructural connections after surgical decompression in patients with DCM
The study collected preoperative and postoperative brain diffusion tensor imaging and diffusion spectrum imaging data of 22 patients with DCM (age = 56.
9 ± 9.
1 years)
.
Paired t-tests were used to identify significant microstructural changes within the cohort, and correlation analysis was used to determine whether these changes were associated with neurological improvement
The study collected preoperative and postoperative brain diffusion tensor imaging and diffusion spectrum imaging data of 22 patients with DCM (age = 56.
Before surgery, higher structural connectivity (SC) was observed in the anterior, posterior, and superior regions of the prefrontal/frontal lobe, anterior cingulate gyrus, internal and external capsules, and corona radiata fibers
After surgery, an increase in the modified Japanese Orthopaedic Association score was associated with increased SC from primary sensorimotor areas to posterior cingulate and precuneus; increased SC between cerebellum and bilateral lingual gyrus; from limbic system areas to basal ganglia and frontal SC decreased
Brain regions with differences in standardized anisotropy values between preoperative and postoperative patients
Brain regions with differences in standardized anisotropy values between preoperative and postoperative patientsFurthermore, increased FA and normalized quantitative anisotropy values of white matter fibers responsible for transmitting sensory information and motor coordination and planning were associated with neurological improvement in patients with DCM after surgery
.
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Furthermore, increased FA and normalized quantitative anisotropy values of white matter fibers responsible for transmitting sensory information and motor coordination and planning were associated with neurological improvement in patients with DCM after surgery
Correlation between increased postoperative FA value and increased mJOA score in patients with DCM (ΔmJOA)
Correlation between increased postoperative FA value and increased mJOA score in patients with DCM (ΔmJOA)Correlation between mJOA score and FA value of four fiber bundles
Correlation between mJOA score and FA value of four fiber bundlesIn conclusion, the team believes that restoration of the microstructural integrity of the corticospinal tract and other sensorimotor pathways, as well as supraspinal reorganization of microstructural connections in sensory and motor-related areas, is associated with improved neurological function after surgical decompression
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Restoration of microstructural integrity of the corticospinal tract and other sensorimotor pathways, and supraspinal reorganization of microstructural connections in sensory- and motor-related regions are associated with improved neurological function after surgical decompression
original source
original sourceWang C, Ellingson BM, Salamon N, Holly LT.
Wang C, Ellingson BM, Salamon N, Holly LT.
https://journals.
lww.
com/neurosurgery/Abstract/9900/Recovery_of_Supraspinal_Microstructural_Integrity.
106.
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