The Evaluation and Prediction of Laminoplasty Surgery Outcome in Patients with Degenerative Cervical Myelopathy Using Diffusion Tensor MRI

Abstract

BACKGROUND AND PURPOSE: DTI has been proved valuable for the diagnosis of degenerative cervical myelopathy, whereas its capacity for predicting the outcome of surgery is still under debate. Here we conduct a prospective cohort study to analyze the capacity of DTI for evaluating and predicting laminoplasty surgery outcome for degenerative cervical myelopathy. MATERIALS AND METHODS: We recruited 55 patients with degenerative cervical myelopathy who underwent DTI before surgery and at 3- and 6-month follow-up stages, and 20 healthy subjects. For clinical assessment, the modified Japanese Orthopedic Association scale was recorded for each patient at different stages. DTI metrics were compared between patients before surgery and healthy subjects. Spearman correlation and receiver operating characteristic were used to analyze the evaluation and prediction capacity of DTI for the modified Japanese Orthopedic Association scale, respectively. We analyzed different vertebral levels: maximal compression level, average of all compression levels, and C2 level. RESULTS: = .04). CONCLUSIONS: The DTI metrics before laminoplasty surgery, especially fractional anisotropy at the C2 level, have the potential for evaluating and predicting the degenerative cervical myelopathy surgery outcome.